DSM-5 – Was ändert sich für die Suchttherapie und -forschung?

Abstract

The new edition of the DSM, which was published in May of 2013, has brought the following changes in the now called category "substance-related and addictive disorders". The terms dependency and misuse or abuse will be replaced by the terminus "substance use disorder". There is a moderate substance use disorder, if two or three criterias are fulfilled for a period of 12 months. To speak of a severe substance use disorder, it has to be four or more criteria for the duration of 12 months. Furthermore, pathological gambling will be a part of the DSM-5 as a non-substance use disorder, but rather an addictive disorder. It is possible, that internet addiction will be a part of a revised version in DSM-5 for addictive disorders. The now changed criteria will have consequences on diagnosis, therapy and research concerning substance-related and addictive disorders. The leading diagnosis standards DSM-5 and ICD-10 or the following ICD-11 will continue to drift further apart from each other.

New developments in the management of opioid dependence: focus on sublingual buprenorphine–naloxone

“…Both classification systems list eleven symptoms for opioid-use disorders. The recent DSM-5 has given up the long-standing categorical distinction between abuse (or harmful use) and dependence, and adopted a dimensional approach: 6 , 7 it specifies eleven symptoms, whereby the presence of two to three symptoms indicates a mild disorder, four to five a moderate, and six or more a severe disorder.…”

Multiple Prescription Drug Abuse and Salt Craving in a Psychotic Patient: A Case Report From a Teaching Hospital in Jordan

“…According to DSM-IV Criteria for major depressive disorder, the patient was diagnosed to have depression because 6 out of 9 criteria were met as the following: the patient was suffering from a) depressed mood or irritable most of the day, nearly every day such as feeling sad or empty; b) decreased interest or pleasure in most activities, most of each day; c) significant weight change (5%) or change in appetite; d) change in sleep and insomnia, she sometimes spent 2 to 3 days without sleeping at all; e) fatigue or loss of energy; f) suicidality: Thoughts of death or suicide, and had suicide trials several times ( 7 ). According to the ICD-10 Classification of mental and behavioral disorders, this is an obvious case of multiple drug abuse and salt/salty food harmful use and dependence.…”

Suchterkrankungen im Diagnostischen und Statistischen Manual Psychischer Störungen DSM-5

“…Es wird in Aussicht gestellt, dass die ICD-11 die kategoriale Unterscheidung zwischen "schädlichem Gebrauch" und "Abhängigkeit" nicht aufheben werde und die bisherigen sechs diagnostischen Abhängigkeitskriterien auf drei kondensiert würden, von denen nur noch eines erfüllt sein müsse. In Bezug auf die Alkoholerkrankung könnte es neben dem schädlichen Gebrauch und der Abhängigkeit noch eine Kategorie "riskanter Konsum" geben (6). Falls dieses so zutreffen sollte, würden sich zukünftig die beiden großen Klassifikationssysteme DSM und ICD auf diesem Gebiet eher wieder voneinander entfernen.…”

“…Baumgärtner et al (6) setzen sich kritisch mit dem diagnostisch-klassifikatorischen Ansatz des DSM-5 auseinander. Die Entwicklung des DSM führe von der traditionellen kategorialen Einteilung auf Grundlage diagnostischer Symptomcluster hin zu einem dimensionalen Krankheitskonzept unterschiedlicher Schweregrade.…”