Presentation Information
[SY-14-03]Fundamental questions for the future of the DSM
*Roberto Lewis-Fernandez (Columbia/NYS Psychiatric Institute(United States of America))
Keywords:
DSM,cultural psychiatry,psychiatric classification
The role of cultural psychiatry in the Diagnostic and Statistical Manual (DSM) has grown considerably since DSM-III (1980). DSM-5-TR (2022) now includes dedicated sections on cultural issues in the general introduction and disorder chapters as well as a separate Culture and Psychiatric Diagnosis chapter, which includes the Outline for Cultural Formulation and the Cultural Formulation Interview. The American Psychiatric Association is beginning to explore the next iteration of the DSM, which is due in several years. This iteration is faced with two unresolved questions relating to cultural material: 1) how to fully integrate findings on global phenomenological variation? and 2) what is the role of social-structural factors in the onset and evolution of mental disorders? Integrating phenomenological variation is thwarted by the nomothetic approach that characterizes DSM since 1980, evidencing the Manual’s decision to prioritize a premature reliability over local and person-centered validity. The impact of ways of societal organization (e.g., laws, overarching political ideologies and mores) that give rise to specific social determinants of mental health raises questions about the role of social environments in the etiology and pathophysiology of mental disorders. How fundamental are social conditions to the building blocks of disorder in addition to their role as determinants of service use? This presentation will describe these two questions and provide alternatives for future DSMs.