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October 1990

Is DSM-IV Needed at All?

Author Affiliations

Medical College of Pennsylvania at EPPI 3200 Henry Ave Philadelphia, PA 19428

Arch Gen Psychiatry. 1990;47(10):974-976. doi:10.1001/archpsyc.1990.01810220090012

To the Editor.—  I wrote an article for the December 1988 issue of the Archives in which I posed the question, "Why Are We Rushing to Publish DSM-IV?"1 When I wrote that article DSM-IV was scheduled for publication in 1992, 5 years after the DSM-III-R publication date.2I delineated a number of problems that might result from the publication of a third DSM edition in 12 years. In brief, these problems are the following: (1) an insufficient amount of time between DSM editions to allow the accumulation of replicated research necessary to justify a change in diagnostic criteria; (2) the expenditure of resources to compare the new diagnostic criteria with the old and thus reduce the effort toward discovering pathophysiologic mechanisms; (3) difficulties in interpreting and resolving discrepant research findings based on different criteria sets; (4) an increased number of diagnostic errors because of the lack of time

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