Originally posted 2016-09-02 09:14:39.
Prior to the release of DSM-5 in 2013, I referred at times to the pocket copy of DSM IV parked in my office bookcase. The main reason was to enter the right diagnostic codes on insurance forms. I also sometimes quoted DSM criteria to show a patient that ADHD can’t arise in adulthood, that daily mood swings are not characteristic of bipolar disorder, or that six months of sobriety is still “early” remission. In other words, aside from fulfilling the documentation needs of third parties, I occasionally used DSM IV to disabuse a patient of a faulty self-diagnosis, and even more occasionally to ratify my own assessment in the eyes of my patient. Rarely, if ever, did I consult the handbook to make a diagnosis. By the time I reached for it, I already had a handle on what was going on.