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Book Forum: Mental Health Care and Diagnosis   |    
A Research Agenda for DSM-V
PEDRO RUIZ, M.D.
Am J Psychiatry 2004;161:1726-a-1727. doi:10.1176/appi.ajp.161.9.1726-a
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Edited by David J. Kupfer, M.D., Michael B. First, M.D., and Darrel A. Regier, M.D., M.P.H. Arlington, Va., American Psychiatric Association, 2002, 307 pp., $39.00 (paper).

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It seems like it was only yesterday that DSM-IV was published, and yet we are already planning the forthcoming DSM-V. A Research Agenda for DSM-V depicts, in many ways, the completion of the first phase of the DSM-V planning process. It consists of six chapters made up of white papers focusing on the DSM-V process as well as some of its future content. The editors make it clear that this book in no way represents the initial stage of the DSM-V revision process. I think that this statement is an appropriate and timely message to the field.

This publication emanated from a close collaboration between APA and the National Institute of Mental Health (NIMH). The goal was to provide guidance and research stimulus directed at improving the scientific basis of future diagnostic classification efforts. I think that this goal is relevant and laudatory. Certainly, this type of scientific foundation will ultimately improve the validity of future diagnostic classifications as well as add strength to the preventive and treatment efforts that will ensue from this strong scientific base.

In DSM-III, disorders were defined as syndromes. DSM-IV maintained a descriptive approach and incorporated empirical research findings and the outcome of existing epidemiological and clinical research data. One hopes that DSM-V will retain the emphasis on solid scientific research outcomes. This book is an essential effort in this direction; that is, it was prepared as a way of stimulating relevant research activities in areas of current importance and relevance to the field. This objective, in my opinion, is very valuable for the next phases of the DSM-V conceptualization and completion, planned for the year 2010.

In 1999, APA and NIMH convened the first DSM-V research planning conference, where areas of research importance were identified for the field. Five areas were identified as essential: 1) developmental issues, 2) gaps in the current system, 3) disability and impairment, 4) neurosciences, and 5) nomenclature. In 2000, the chairs of the five work groups in these areas held another conference to define the work process for the white papers represented in this book. Liaisons with NIMH, the National Institute on Drug Abuse, and the National Institute on Alcohol and Alcohol Abuse were established. Also in 2000, a third conference was held, and a cross-cultural work group was added. Subsequently, this volume’s six chapters were produced by these working groups. I should add that, in my opinion, the addition of the work group on cross-cultural psychiatry was a much-needed and beneficial step for the field at large.

Undoubtedly, realistic limitations on what can be accomplished with DSM-V exist. Nevertheless, efforts to further the development of a solid and scientific research base that could enhance the validity of DSM-V is of utmost importance. This book is a good step toward this development. I congratulate the authors of the six chapters of this book as well as its editors. Without question, this volume represents a far-reaching effort and a good start for the work ahead. One hopes that all of the goals in hand for a successful and well-accepted DSM-V will be met not only in the United States but across the world as well.

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