Obsessive-Compulsive Spectrum Disorders

The five-year process of preparing for the revision of the
Diagnostic and Statistical Manual (DSM) has been organized around a series
of conferences convened by the American Psychiatric Association, in
collaboration with the World Health Organization and the U.S. National
Institutes of Health, to address the future of psychiatric diagnosis.
Obsessive-Compulsive Spectrum Disorders: Refining the Research Agenda
for DSM-V is the fruit of one of those conferences and presents the
most academically sound, thought-provoking, and timely papers from the
proceedings.

As the conference and book demonstrate, recent advances
in psychiatric diagnosis suggest a new approach to obsessive-compulsive
disorder (OCD) classification:


* Research into the pathogenesis of OCD increasingly supports
reclassification out of the anxiety disorders and into a separate group of
obsessive-compulsive-related disorders (OCRDs).
* The relationships
among OCRDs may be better defined, delineated, and understood if the current
categorical diagnostic approach is supplemented with a dimensional approach
which assesses obsessive-compulsive symptom domains.
*
Obsessive-compulsive disorders are believed to be underdiagnosed in patients
who complain of broad symptoms of anxiety, and reclassification of OCD as an
OCRD would promote more careful examination of distinct obsessive-compulsive
symptoms, yield more accurate diagnosis, and result in more effective
treatments.
* Reclassification may facilitate future research directions
in examining the biological underpinnings of these disorders.

In
addition to examining the genetic, neurological, and ethno-cultural bases
for OCRDs, the book gives special attention to disorders that cross current
diagnostic categories, including:


* Body dysmorphic disorder (BDD)
* Tourette's syndrome and
trichotillomania
* Impulse-control disorders

The process leading
to publication of DSM-V is by its nature an exhaustive and complex one, and
the conferences play a critical role in reviewing relevant research,
assessing the status of scientific knowledge, and advancing that knowledge
base. Obsessive-Compulsive Spectrum Disorders: Refining the Research
Agenda for DSM-V represents the cutting-edge thinking that will
culminate in new diagnoses, classifications, and standards of practice for
this debilitating set of disorders. Clinicians and academicians will be
fascinated by this glimpse into the next generation of the DSM-V.