background The leading diagnostic classification system used in the Dutch mental health care system is the dsm-iv (Diagnostic and Statistical Manual of Mental Disorders). The next version, dsm-5, will probably be published in 2013. The new version aims to pay more attention to cultural diversity; this will have implications for treatment and research.
aim To discuss the most important aspects of dsm-5 that have culture relevance.
method A Medline search was conducted for the period 1990- 2011 on the basis of the search terms ‘dsm’, ‘icd’, ‘dsm-classification’, ‘psychiatric classification’, ‘psychiatric diagnosis’, ‘culture’ and ‘diversity’.
results Taking the example of depression and anxiety, one must conclude that the diagnostic system does not achieve its aims. It might be possible to compensate for this shortcoming by introducing a dimensional-categorical system. Such a system would be particularly important for cultural psychiatry and psychology in relation to matters such as subsyndromal symptom categories, experience of illness, behaviour during illness, the transition from normality to deviancy, culturally responsive research, and links to cultural neuroscience.
conclusion It looks as if such a major paradigm shift will not occur until dsm-6.