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

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. Maria Oquendo, Chair of the Future DSM Strategic Committee, will serve as Session Chair. Dr. Jonathan Alpert (Vice Chair of the Future DSM Strategic Committee) will review the historical trajectory of the DSM, the scientific and practical reasons for current reevaluation, and the overarching framework guiding the committee’s efforts. He will also highlight challenges and the need for a system that can more flexibly incorporate new discoveries. He will outline potential next steps for evolving the DSM— including governance structures, integration strategies, and stakeholder engagement, and 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. Dr. Dost Öngür (Chair of the Future DSM Structure and Dimensions Subcommittee) 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 (Chair of the Future DSM Biomarker Subcommittee) 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. Dr. Nitin Gogtay (Vice Chair of the Future DSM Strategic Committee), Session Discussant, will summarize themes and moderate the discussion.

References

Oquendo MA, Abi-Dargham A, Alpert JE, Benton TD, Clarke DE, Compton WM, Drexler K, Fung KP, Kas MJH, Malaspina D, O’Keefe V, Öngür D, Wainberg ML, Yonkers KA, Yousif L, Gogtay N, Initial Strategy for The Future of The Diagnostic and Statistical Manual (DSM). Am J Psychiatry, in press Öngür D, Abi-Dargham A, Clarke DE, Compton WM, Cuthbert B, Fung KP, Gogtay N, Kas MJH, Kumar A, Malaspina D, O’Keefe VM, Oquendo MA, Wainberg ML, Yonkers KA, Yousif L, Alpert JE The Future of DSM: A Report from the Structure and Dimensions Subcommittee. Am J Psychiatry, in press.