Disorders, sublime menu: the DSM-5

The release of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the culmination of a long and remarkably public discussion which was accompanied by a great deal of controversy. Diagnostic criteria for many disorders have changed, the structure of the DSM is different, and there remain significant concerns about the forensic application of the DSM. This column briefly covers the primary changes and summarises the debate about various diagnoses, with a particular focus on diagnoses of relevance to medico-legal psychiatry and the legal system. Underlying concerns about the validity of diagnostic criteria and their applicability to forensic issues are discussed. Concerns about the DSM-5 are not only due to the specific diagnoses and their criteria, but the methodology of checklist criteria. This is amplified in medico-legal settings, but is also in part necessary. Clinicians, lawyers, and judges will all need to think carefully about how they use the DSM and its ilk in forensic settings.