The DSM-IV Text Revision: rationale and potential impact on clinical practice

One consequence of the longer interval between major revisions of the DSM(from seven years between DSM-III-R and DSM-IV to more than 15 years between DSM-IV and DSM-V) is that the accompanying descriptive text will become increasingly out of step with the psychiatric database. To remedy this problem, the DSM-IV Text Revision (DSM-IV-TR) was published in July 2000. The main objectives of the revision were to review the DSM-IV text and make changes to reflect information newly available since the close of the initial DSM-IV literature review process in mid-1992; to correct errors and ambiguities that have been identified in DSM-IV; and to update the diagnostic codes to reflect changes in the ICD-9-CM coding system the U.S. government uses officially for health care reporting. This paper reviews the rationale for the text revision and describes changes that may have an impact on the day-to-day use of DSM-IV.