Since the DSM-IV® was published in 1994, we’ve seen many advances in our knowledge of psychiatric illness. This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders published since DSM-IV® was completed in 1994. Updated information is included about the associated features, culture, age, and gender features, prevalence, course, and familial pattern of mental disorders.

The DSM-IV® brings this essential diagnostic tool up-to-date, to promote effective diagnosis, treatment, and quality of care. Now you can get all the essential diagnostic information you rely on from the DSM-IV® along with important updates not found in the 1994 edition.

Stay current with important updates to the DSM-IV®:

• Benefit from new research into Schizophrenia, Asperger’s Disorder, and other conditions
• Utilize additional information about the epidemiology and other facets of DSM conditions
• Update ICD-9-CM codes implemented since 1994 (including Conduct Disorder, Dementia, Somatoform Disorders)

DSM-IV-TR, the handheld version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, is now available for both Palm OS and PocketPC handhelds. This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders and includes associated features, culture, age, and gender features, prevalence, course, and familial pattern of mental disorders. And with Skyscape's patented smARTlink™ technology, DSM-IV-TR can easily cross-index with other clinical and drug prescription products from Skyscape to provide a powerful and integrated source of clinical information that you can carry with you wherever you go!

Lee J. Markowitz, Department of Psychology, University of Waterloo (Ontario, Canada)

62 of 73 found the following review helpful:


Great for Psychologists, disappointing for Psychiatrists  Dec 19, 2002 By Richard C. Jensen
Of course, this is the bible of mental disorder diagnoses, at least in the U.S. The diagnoses are pretty inclusive, but there are several problems with this book as it pertains to the practice of Psychiatry. First, the book offers about 900 pages on symptom diagnosis, and about half a paragraph on the types of psychiatric medications that are effective for the particular diagnosis. 95% of diagnoses have absolutely no recommendations for treatment.

This leads to the second problem: differentiation of primary vs. secondary symptoms. The primary symptoms are the cornerstone of diagnosis. The secondary symptoms take way too much space in this book, and are generally not helpful in making a diagnosis, because the vast majority of secondary symptoms overlap in most mental illnesses. The important use for secondary symptoms is for the type of therapy that should be used (psychotherapy or pharmacotherapy). For example, if two patients are depressed, the diagnosis is made from primary symptoms (tiredness, irritability, difficulty concentrating, psychomotor retardation). However, if patient "A" has no significant secondary symptoms like anxiety or insomnia, they can take a high dose of SSRI or Effexor. But if patient "B" has the secondary symptoms of prominent anxiety and insomnia, Remeron or Serzone may be more helpful, and perhaps a benzodiazepine can be added.

The DSM IV does nothing to further the practicality of psychiatry. And that's a shame, because only a few hundred extra pages of pharmacotherapy recommendations would make the book so much more helpful to psychiatrists, who currently waste a lot of time experienting with every drug for the treatment-resistant patients. Some drugs work better for some people based on secondary symptoms, which cannot be ignored in the choice of drug treatment. A good book that does match secondary symptoms to drug treatment is The Failures of American Medicine.

50 of 62 found the following review helpful:


One Small Step for Man, One Giant Leap For the Insurance Industry  Sep 19, 2005 By Peter B. Dunn MD
The DSM is very clearly written and can be understood by anyone no matter what his or her educational level. It also contains an exceptional psychiatric glossary and an exceptional psychoanalytically oriented section describing the "defense mechanisms." The public is ambivalent about psychiatry but has embraced the DSM because it provides readers with the illusion that if you read this book you can diagnosis yourself and your acquaintances. What most mental health professional know is that this book is a political document as well as a scientific one. It advances the cause of the psychobioligists (over the environmentalists) and the alliance of drug companies, insurance companies and psychopharmacologists. What the sub-committees who wrote each section of the DSM have done is to organize the vast array of life problems that we have long thought of as "neurotic" (and stemming from early family experience) and placed them side by side with clearly biological diseases like schizophrenia and manic-depression. Why? The aim is to create the impression that all of the ordinary habitual problems in love and work that pretty much everyone agrees come from the way you were brought up in your family are in fact biological - and probably inherited - illnesses. Chronic unhappiness, for example, is coded with the "mood disorders" like classic manic depressive illness. Another facet of the DSM that is pernicisous is that each problem the patient has must be coded separately. There is no way to describe the patient in holistic terms. The patient as described by the DSM (and treated by the psychiatrist guided by this document) ends up looking something like a cubist painting by Picasso. What is discouraged is trying to understand the person's various problems as interrelated parts of a comprehensible whole that has developed over a lifetime from a continual ongoing interaction between the person's life experience and their biology. Among the most pernicious effects of the DSM has been its influence on psychiatric education. Psychiatric trainees are encouraged to use the DSM as their first approach to the patient. It is very sad to see these fledglings struggle to make diagnosis rather than to understand their patient. Do they ask whether the patient has a brother or a sister or was born rich or poor. No! Conference after conference is devoted to figuring out which DSM category the patient fits into. No one dares tells the trainee the little secret of the DSM, which is that about half of patients don't fit into any category at all. Some of us, of course, do have OCD or ADD or are narcissistic or suffer from moderate autism (Asperger's Syndrome) but most of us are not so neatly described. Most people have to be squeezed into categories that we don't fit into. The overall chairman of the committee that wrote the DSM IV (Dr. Allen Frances) has, to his credit, acknowledged (in a New Yorker magazine interview) that the DSM IV categories are neither valid nor reliable and don't describe (in his words) "reality." All of this said, the DSM is a crystalline clearly written document that well summarizes contemporary descriptive psychiatry.

26 of 34 found the following review helpful:


Blue Shirt, Partially-Untucked, Red Tie, Ushanka Bedecked Disorder  Jul 12, 2006 By My Uncle Stu
Hey, it is what it is. I've heard people discuss DSM-IV-TR as if it were the bible of psychiatry, the ultimate textbook of psychiatric pathology. On the other side are the people who would throw it out completely in fear that any label applied to anyone dehumanizes them, reduces them to a category, dooms them to a lifetime of struggling with their new pathological identity.

DSM is for research purposes. It is a collection of constellations of symptoms, compiled by clinicians, organized into categories by vote of committee, and it does make convenient shorthand for describing patients. If you want to do a study looking at how people respond to a certain medication versus placebo, you need some kind of criteria for deciding which people are appropriate to include in the study, some kind of rigorous way to establish the parameters so that each subject isn't a soft call, and that is what DSM is appropriate for. It's big on reliability, low on validity. Its inter-rater reliability is also what makes it a convenient shorthand for describing patients to other clinicians (or, more often and more urgently, to insurance utilization reviewers). I'm not going to review hours of process notes in a presentation, but if I say someone suffers from recurrent severe major depression with psychosis, you quickly know some relevant things about what the problems are. Even with the big garbage bin categories of schizoaffective disorder or cognitive brain disorder not otherwise specified, you can at least characterize someone within the right ballpark. But that's as far as it is useful for and that's as far as it should be used. Diagnosis is a tricky part of individual patient care and often the hunt for diagnostic precision is a distracter. It plays into to reification myths, the idea that attaching a name to something makes it a distinct, concrete entity. All of these symptoms exist on spectrums, most psychiatric symptoms in their mild to moderate forms can be a normal part of life, and the search for concrete categories can lead us down the wrong road when it drives the treatment rather than being one piece in the formulation of an individual patient. By the way, if there is any doubt that DSM categories are nothing more than descriptions of observations, let the diagnosis "intermittent explosive disorder" illustrate the case, the mostly inanely concrete and pointless reification of anger and/or impulsiveness as a distinct syndrome. It's not just impractical, it's downright embarrassing. An article appeared in the local paper about a proposed link between road rage and intermittent explosive disorder, and two separate patients brought it into session, mockingly questioning me on the authenticity of this diagnosis.

It is what it is. Worth studying and being very familiar with since it serves as an oft referenced interface between research, Big Pharm, the clinical world, and the business world. Worth studying as, just as the acronym suggests, a statistical manual of carved out syndromes negotiated by mostly dull men sitting through dull meetings. I've never been involved, but I picture constipated men, with coffee and stale non-dairy creamer breath intermingled with a musty smell from their clothes. And these men are passionately arguing and negotiating, with their prides on the line. But that's not really the point, sorry. The point is, if DSM categories are anything other than a minor factor in guiding how you care for your patients, that is your sloppiness. Let's not blame an inert stack of papers for not living up to the sacredness that's been fallaciously imposed on it.

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