Journal article

Diagnostic inflation in the DSM: A meta-analysis of changes in the stringency of psychiatric diagnosis from DSM-III to DSM-5

Fabian Fabiano, Nick Haslam

CLINICAL PSYCHOLOGY REVIEW | PERGAMON-ELSEVIER SCIENCE LTD | Published : 2020

Abstract

It is often argued that successive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have relaxed diagnostic criteria and thereby inflated rates of diagnosis. This claim has yet to be examined systematically. We quantitatively reviewed 123 studies in which one sample was concurrently diagnosed using two consecutive DSM editions (i.e., DSM-III & DSM-III-R, DSM-III-R & DSM-IV, or DSM-IV & DSM-5). Meta-analysis of 476 risk ratios enabled 123 comparisons of diagnostic rates for specific disorders. Comparisons demonstrating diagnostic inflation (i.e., higher diagnostic rate in the later edition) did not exceed those demonstrating deflation. The average risk ratio was 1.0..

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Grants

Awarded by Australian Research Council


Funding Acknowledgements

Funding for this study was provided by Australian Research Council grant DP170104948. The funding agency had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.