The American Psychiatric Association revised the timeline for publishing the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, moving the anticipated release date to May 2013.

"Extending the timeline will allow more time for public review, field trials and revisions," said APA President Alan Schatzberg, M.D. "The APA is committed to developing a manual that is based on the best science available and useful to clinicians and researchers."

The extension will also permit the DSM-5 to better link with the U.S. implementation of the ICD-10-CM codes for all Medicare/Medicaid claims reporting, scheduled for October 1, 2013. Although ICD-10 was published by the WHO in 1990, the "Clinical Modification" version (ICD- 10-CM) authorized by the U.S. Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control (CDC) is not being implemented in the U.S. until 23 years later.

The ICD-10-CM includes disorder names, logical groupings of disorders and code numbers but not explicit diagnostic criteria. The APA has already worked with CMS and CDC to develop a common structure for the currently in-use DSM-IV and the mental disorders section of the ICD- 10-CM.

The International Classification of Diseases (ICD) is published by the WHO for all member countries to classify diseases and medical conditions for international health care, public health, and statistical use. The WHO plans to release its next version of the ICD, the ICD-11, in 2014.

APA will continue to work with the WHO to harmonize the DSM-5 with the mental and behavioral disorders section of the ICD-11. Given the timing of the release of both DSM-5 and ICD-11 in relation to the ICD-10-CM, the APA will also work with the CDC and CMS to propose a structure for the U.S. ICD-10-CM that is reflective of the DSM-5 and ICD-11 harmonization efforts. This will be done prior to the time when the ICD-10-CM revisions are "frozen" for CMS and insurance companies to prepare for the October 1, 2013, adoption.

The Timeline

David Kupfer, M.D., chair of the DSM-5 Task Force, which is in charge of the DSM revision process, noted that draft changes to the DSM will be posted on the DSM-5 Web site in January 2010. Comments will be accepted for two months and reviewed by the relevant DSM-5 Work Groups in each diagnostic category. Field trials for testing proposed changes will be conducted in three phases.

The process for developing the DSM-5 began a decade ago, with an initial research planning conference under the joint sponsorship of the APA and the National Institute of Mental Health. Additional global research planning conferences, under the auspices of the American Psychiatric Institute for Research and Education (APIRE), the World Health Organization, and three institutes of the National Institutes of Health produced a series of monographs, which helped lay the groundwork for the revisions. The APA's DSM-5 Task Force and Work Group members were identified in 2007; they are tasked with reviewing scientific advances and research to develop draft diagnostic criteria in diagnostic categories of psychiatric disorders. Information about the revision process is available online at

The American Psychiatric Association