Background: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-
5, was approved by the Board of Trustees of the American Psychiatric Association (APA) on December 1, 2012, and released
on May 18, 2013. The DSM-5 is the first major edition of the manual in nearly twenty years. Although designed for
use in the United States, the DSM diagnostic system is widely used around the world.
Objectives: To summarize the changes to the overall structure and conceptualization of the DSM-5.
Methods: The author reports on information disseminated at training sessions for psychiatrists representing their District
Branches held at the APA’s 2013 Annual Meeting. This is the first in a series of articles that will describe and explain the
changes introduced into the DSM-5. This article focuses on the “metastructure” of the DSM-5.
Conclusions: The DSM-5 differs in many fundamental ways from previous versions of the manual, and reflects an ongoing
attempt to bring psychiatry into the mainstream of medicine as well as to adapt to anticipated continuing rapid changes
within the field.