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on June 2, 2003
Like other reviewers, I agree that if you own DSM-IV (burgundy cover), there is absolutely no reason for you to purchase the DSM-IV-TR (silver cover). Might as well wait for DSM-V (won't that be a treat). If you are not a mental health professional or graduate student, I can't imagine why you would want to own this book. It is essentially a compilation of symptom and behavior checklists that help clinicians make reliable diagnoses of mental disorders.
I would recommend strongly (for both professionals, students, and the lay public), DSM-IV Made Easy by James Morrison. Morrison's book makes the DSM come alive. He illustrates technical points well, and provides interesting case examples that make you think of people when you read the diagnosis, not just symptoms.
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on February 27, 2003
The diagnostic sections remain largely unchanged. Only significant changes were to the text portion, hence the TR designation-- text revised. This is important if you are a student or in a research position. They produced this version in response to the fact that many graduate programs are using the DSM as a text book in their Pathology courses. In this regard, the new version is worthwhile and clearly justified. It also buys them a little more time in development of the DSM V. For clinical purposes, don't bother, it's not worth the money. If you are getting your first copy, or are looking for class, then you want this edition.
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on December 23, 2001
The text-revised version is virtually identical to the 1994 version of the DSM-IV and not worth buying if you have the 1994 version. Along with the DSM-IV, the DSM-IV Text Revised version is, however, an informative book that provides good introductory information, especially in the "Diagnostic Features" section, about a wide variety of mental disorders. A problem of the manual, in my opinion, is its use of a categorical classification system while ignoring the dimensional nature of psychological phenomena.
Lee J. Markowitz, Department of Psychology, University of Waterloo (Ontario, Canada)
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on September 2, 1999
Thanks to the reviewers from Tuscon & Bowling Green who point out that this is only a tool that attempts to codify the many mental states we collectivly term mental disorders. As a clinician I find it useful as a quick refererence but it doesn't replace good case studies, in depth works and clinical experience.
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on December 19, 2002
Of course, this is the bible of mental disorder diagnoses, at least in the U.S. The diagnoses are pretty inclusive, but there are several problems with this book as it pertains to the practice of Psychiatry. First, the book offers about 900 pages on symptom diagnosis, and about half a paragraph on the types of psychiatric medications that are effective for the particular diagnosis. 95% of diagnoses have absolutely no recommendations for treatment.
This leads to the second problem: differentiation of primary vs. secondary symptoms. The primary symptoms are the cornerstone of diagnosis. The secondary symptoms take way too much space in this book, and are generally not helpful in making a diagnosis, because the vast majority of secondary symptoms overlap in most mental illnesses. The important use for secondary symptoms is for the type of therapy that should be used (psychotherapy or pharmacotherapy). For example, if two patients are depressed, the diagnosis is made from primary symptoms (tiredness, irritability, difficulty concentrating, psychomotor retardation). However, if patient "A" has no significant secondary symptoms like anxiety or insomnia, they can take a high dose of SSRI or Effexor. But if patient "B" has the secondary symptoms of prominent anxiety and insomnia, Remeron or Serzone may be more helpful, and perhaps a benzodiazepine can be added.
The DSM IV does nothing to further the practicality of psychiatry. And that's a shame, because only a few hundred extra pages of pharmacotherapy recommendations would make the book so much more helpful to psychiatrists, who currently waste a lot of time experienting with every drug for the treatment-resistant patients. Some drugs work better for some people based on secondary symptoms, which cannot be ignored in the choice of drug treatment. A good book that does match secondary symptoms to drug treatment is The Failures of American Medicine.
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on September 19, 2005
The DSM is very clearly written and can be understood by anyone no matter what his or her educational level. It also contains an exceptional psychiatric glossary and an exceptional psychoanalytically oriented section describing the "defense mechanisms." The public is ambivalent about psychiatry but has embraced the DSM because it provides readers with the illusion that if you read this book you can diagnosis yourself and your acquaintances. What most mental health professional know is that this book is a political document as well as a scientific one. It advances the cause of the psychobioligists (over the environmentalists) and the alliance of drug companies, insurance companies and psychopharmacologists. What the sub-committees who wrote each section of the DSM have done is to organize the vast array of life problems that we have long thought of as "neurotic" (and stemming from early family experience) and placed them side by side with clearly biological diseases like schizophrenia and manic-depression. Why? The aim is to create the impression that all of the ordinary habitual problems in love and work that pretty much everyone agrees come from the way you were brought up in your family are in fact biological - and probably inherited - illnesses. Chronic unhappiness, for example, is coded with the "mood disorders" like classic manic depressive illness. Another facet of the DSM that is pernicisous is that each problem the patient has must be coded separately. There is no way to describe the patient in holistic terms. The patient as described by the DSM (and treated by the psychiatrist guided by this document) ends up looking something like a cubist painting by Picasso. What is discouraged is trying to understand the person's various problems as interrelated parts of a comprehensible whole that has developed over a lifetime from a continual ongoing interaction between the person's life experience and their biology. Among the most pernicious effects of the DSM has been its influence on psychiatric education. Psychiatric trainees are encouraged to use the DSM as their first approach to the patient. It is very sad to see these fledglings struggle to make diagnosis rather than to understand their patient. Do they ask whether the patient has a brother or a sister or was born rich or poor. No! Conference after conference is devoted to figuring out which DSM category the patient fits into. No one dares tells the trainee the little secret of the DSM, which is that about half of patients don't fit into any category at all. Some of us, of course, do have OCD or ADD or are narcissistic or suffer from moderate autism (Asperger's Syndrome) but most of us are not so neatly described. Most people have to be squeezed into categories that we don't fit into. The overall chairman of the committee that wrote the DSM IV (Dr. Allen Frances) has, to his credit, acknowledged (in a New Yorker magazine interview) that the DSM IV categories are neither valid nor reliable and don't describe (in his words) "reality." All of this said, the DSM is a crystalline clearly written document that well summarizes contemporary descriptive psychiatry.
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on June 20, 1999
DSM-IV is a manual for use by mental health professionals so that there is uniformity in diagnosis and basis for future research. Each diagnosis has been subject to extensive research. DSM-IV only describes symptoms and does not discuss causes for disorders. I would agree with the other reader that I would like to see diagnosis related to anger disorders appearing in future editions. Because there is political concern about anger disorders being used as criminal defenses, the mental health community has been somewhat reluctant to formalize diagnosis in this area. I feel, however, this is important so that the mental health community can be more active in reasearch on anger disorders to provide more effective treatment in this area.
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on June 16, 2000
This manual was excellent for helping the Behavioral Scientist, and Psych student. I would recommend that every Social Science student get one, to help them through the core courses of their quest to get a degree. I also recommend the "companion" to the DSM. That's very helpful too.
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on January 18, 2005
Anyone who reviews this book and gives it less than a 4 or 5 is obviously uneducated about clinical disorders. This is the bedrock of clinical psychology and psychiatry, and, even if it is flawed in philosophy or content, has NO peer. I recommend this book only for those who understand the scientific method and those interested in pursuing graduate study of psychology or psychiatry.
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on September 13, 1998
As an early childhood clinical consultant, it is important with a diagnostic tool such as DSM IV, to not use as a guide to self-diagnose or to diagnose your child. It is also important to note that diagnosis is made using the behavioral characteristics and measurements of duration, frequency and severity of behaviour. Also, it is important to be able to understand dual-diagnosis children, and children who present same symptoms as AD(H)D, yet may actually be depressed, anxious, or even have Tourette's as a primary diagnosis.Work with your elementary school, or day care facility to examine the environmental changes you can make to accommodate a child's attention span. And remember, medication is a last resort. Consult your pediatricians, please.
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