Psychiatric Terminology - Nomenclature

AMA Manual of Style - Stacy L. Christiansen, Cheryl Iverson 2020

Psychiatric Terminology

14.15.1 Diagnostic and Statistical Manual of Mental Disorders (DSM).

The American Psychiatric Association has published 6 editions of a manual for the classification of mental disorders. Each edition has been titled Diagnostic and Statistical Manual of Mental Disorders and has used the abbreviation DSM:

DSM-I (1952)

DSM-II (1968)

DSM-III (1980)

DSM-III-R (1987)

DSM-IV (1994)

DSM-5 (2013)

Note that with DSM-5 the edition number changed from a roman numeral to an arabic numeral (DSM-IV to DSM-5). This change was made to facilitate incremental updates until a new edition is required. Incremental updates will be identified with decimals, for example, DSM-5.1, DSM-5.2.1

Using DSM-5 as an example, these books should be cited as follows:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.

A text revision of DSM-IV was published in 2000 as Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, abbreviated DSM-IV-TR. This book is a revision of the text describing the diagnostic and associated features, prevalence, course, and differential diagnosis of the disorders included in the DSM-IV diagnostic categories. However, the diagnostic classification and criteria in DSM-IV-TR are unchanged from those in the 1994 DSM-IV diagnostic manual. If DSM-IV-TR is cited for diagnostic criteria, it gives the misleading impression that the criteria used differ from those of DSM-IV and date from 2000 rather than 1994. Thus, a citation for the DSM-IV diagnostic criteria should be to DSM-IV (1994). There are no DSM-IV-TR diagnostic criteria per se. If a reference citation pertains to the updated descriptive material in DSM-IV-TR, that should be cited. If a citation pertains to both the DSM-IV criteria and the updated descriptive material in DSM-IV-TR, it would be best to clarify that in the text.

Beginning with DSM-III, the diagnostic system involved an assessment on several axes as follows:

Axis I

Clinical Disorders Other Conditions That May Be a Focus of Clinical Attention

Axis II

Personality Disorders Mental Retardation

Axis III

General Medical Conditions

Axis IV

Psychosocial and Environmental Problems

Axis V

Global Assessment of Functioning

However, “DSM-5 has moved to a nonaxial documentation of diagnosis (formerly Axes I, II, and III), with separate notations for important psychosocial and contextual factors (formerly Axis IV) and disability (formerly Axis V).”2(p16) As Kupfer et al3 note, “This is largely due to its [the multiaxial system’s] incompatibility with diagnostic systems in the rest of medicine, as well as the result of a decision to place personality disorders and intellectual disability at the same level as other mental disorders.”3(p1691)

The new recommendations in DSM-5 have also attempted to ensure “greater harmony between this North American classification system and the International Classification of Diseases (ICD) system.”3(p1691),4

DSM-5 recommends that rather than the Global Assessment of Functioning scale, which had been recommended by DSM-IV for eligibility for short- and long-term disability compensation, the World Health Organization Disability Assessment Schedule5 be used as “the best current measure of disability for routine clinical use.”6

For proper expressions of editions of DSM, see 13.11, Clinical, Technical, and Other Common Terms.

14.15.2 Other Psychiatric Terminology.

For appropriate use of terms and terms to avoid, such as addict, manic, schizophrenic, and hysterical, see 11.1, Correct and Preferred Usage of Common Words and Phrases.

For molecular terms related to psychiatry and neuroscience, see 14.11.5, Molecular Neuroscience.

Principal Author: Cheryl Iverson, MA


Thanks to the following for reviewing and providing comments: Donald C. Goff, MD, JAMA, and Department of Psychiatry, NYU Langone Medical Center, New York, New York; Stephan Heckers, MD, MSc, formerly with JAMA Psychiatry, and Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, Tennessee; and Richard M. Glass, MD, formerly with JAMA.


1.DSM-5 development: frequently asked questions. Accessed July 21, 2019.

2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013. Accessed April 23, 2018.

3.Kupfer DJ, Kuhl EA, Regier DA. DSM-5—the future arrived. JAMA. 2013;309(16):1691-1692. doi:10.1001/jama.2013.2298

4.Using DSM-5 in the transition to ICD-10. Accessed April 23, 2018.

5.WHO Disability Assessment Schedule (WHODAS 2.0). Last updated October 24, 2017. Accessed April 23, 2018.

6.Kupfer DJ, Regier DA. DSM-5 development. Accessed March 21, 2019.