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THE FUTURE DSM: DESIGNING A SCIENTIFIC, INCLUSIVE, AND PRACTICAL DIAGNOSTIC MANUAL FOR MODERN PSYCHIATRY

Nitin Gogtay — American Psychiatric Association

2026 ASCP Annual Meeting

The DSM has long served as the foundational diagnostic manual for mental health worldwide, shaping clinical practice, research, training, and policy. Yet the rapid evolution of neuroscience, clinical research, population health, and data science has created a gap between contemporary scientific knowledge and the static structure of a diagnostic system updated only once per decade. This symposium, grounded in the work of the APA’s future DSM strategic committee and its subcommittees, presents a comprehensive overview of the challenges facing psychiatric diagnosis today and highlights key directions for rethinking the DSM. (Dr. Nitin Gogtay/Maria Oquendo/Jonathan Alpert) will serve as Chair and coordinate discussion. Dr. Nitin Gogtay/Maria Oquendo/Jonathan Alpert) will open the session by reviewing the historical trajectory of the DSM, the scientific and practical reasons for current reevaluation, and the overarching framework guiding the committee’s efforts. This introduction will highlight challenges and the need for a system that can more flexibly incorporate new discoveries. Dr. Dost Öngür will then present a new diagnostic model that reconceptualizes how psychiatric disorders are categorized. He will describe proposed structural model aimed at improving validity, enhancing cross‐diagnostic coherence, and fostering stronger alignment with the underlying biology of mental disorders and contextual factors influencing the diagnoses. Dr. Anissa Abi-Dargham will discuss the efforts of the Biomarker Subcommittee, which will evaluate the readiness and role of biological markers in future DSM development. She will outline the evidentiary standards proposed for the inclusion of such biological factors, highlighting promising candidates, and address methodological, ethical, and implementation considerations. In closing, the first speaker will also outline potential next steps for evolving the DSM—including governance structures, integration strategies, and stakeholder engagement. It will also introduce the vision of transitioning toward a more dynamic, continuously updated DSM—one that functions as a truly living document capable of incorporating scientific advances in real time.

Learning Objective 1: Learn about new proposed model for the next DSM

Learning Objective 2: Learn how future DSM plans to address emerging biomarkers and biological factors

References

  1. Regier DA, Kuhl EA, Kupfer DJ. The DSM-5: Classification and criteria changes. World Psychiatry. 2013 Jun;12(2):92-8. doi: 10.1002/wps.20050. PMID: 23737408; PMCID: PMC3683251 2. First, M. B., Erlich, M. D., Adler, D. A., Leong, S., Dixon, L. B., Oslin, D. W., Goldman, B., Koh, S., Levine, B., Berlant, J. L., and Siris, S. G. (2019). How the DSM Is Used in Clinical Practice. The Journal of nervous and mental disease, 207(3), 157–161. https://doi.org/10.1097/NMD.0000000000000953