The Utopian

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The DSM-5: What social workers need to know

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Beth Pomeroy
Beth Pomeroy

Countless workshops and presentations on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) have garnered professors Beth Pomeroy and Cynthia Franklin a nickname: the DSM-5 Ninjas.

We asked Pomeroy what social workers should know about the new manual, and this is what she shared:

  1. There are four new chapters: Trauma and stressor related disorders, Obsessive Compulsive Disorders, Depressive Disorders, Disruptive Impulse Control Disorders.
  2. The diagnoses within the categories for mental disorders are listed according to lifespan development. For instance, disorders usually found in childhood are listed first followed by adult disorders.
  3. The coding for DSM 5 diagnoses has changed from ICD-9 -CM codes to ICD-10 codes. While the DSM IV-TR was closely linked to the International Classification for Diseases-9th Edition, the DSM 5 has updated the codes to conform to the ICD-10 codes. In fact, the DSM 5 has provided both the ICD-9-CM codes as well as the ICD-10 codes. For example, Schizophrenia is coded 295.90 (F20.9) Schizophrenia with the code in parentheses being the ICD-10 code.
  4. The five axes have been removed. Only the clinical diagnosis is documented followed by V or Z codes. Axis I, II and III were collapsed into a single Primary Diagnosis. If there is a medical disorder accompanying a mental disorder, the medical disorder is listed first. V codes (as listed in the DSM IV-TR) or Z codes (aligned with the ICD-10 codes) are listed after the primary diagnoses and describe the psychosocial and cultural factors that might be impacting the client and the client’s situation.
  5. The DSM-5 now includes a section for each diagnosis on risk for suicidal behaviors.Prior editions of the DSM did not describe the prevalence rates of suicide for each of the mental disorders. With the addition of suicidal risk factors, the clinician can be aware of and assess the client for suicidal thoughts or behaviors . This important information can be a useful tool for clinicians to use in evaluation and treatment considerations of clients.
  6. Goals of the DSM-5 Task Force included reducing the stigma of mental illness and symptom overlap among classifications of mental disorders. Changes will take time to incorporate into agency software programs, insurance claims and licensing exams for social work and other professions. Timeline for these changes will vary from agency to agency and state to state.

Beth Pomeroy is Bert Kruger Smith Centennial Professor in Social Work and co-director of the Institute for Collaborative Health Research and Practice. Learn more about the DSM-5 in Beth Pomeroy’s and Cynthia Franklin’s online seminars offered by the Office of Professional Development.

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