854. The Future of Psychiatric Classification: Strategic Work On A New Diagnostic and Scientific Manual (DSM)
Abstract
Abstract Background The Diagnostic and Statistical Manual of Mental Disorders (DSM) is widely used by healthcare providers. It is a common way for clinicians and researchers across disciplines to understand and codify mental and substance use disorders. In 2024, the American Psychiatric Association’s Board of Trustees approved the creation of a Future DSM Strategic Committee, tasked with monitoring scientific developments in the field that can impact the structure, definition, and criteria of disorders in the DSM. The committee is also entrusted with developing strategies for DSM to incorporate knowledge from the field as it evolves. Aims & Objectives To present a comprehensive overview of the challenges facing psychiatric nosology and highlight key directions for rethinking the DSM to incorporate the rapid evolution of neuroscience, clinical research, population health, and data science to provide a more dynamic and dimensional representation of nosology. It will also highlight how a review of the critiques of the DSM and a goal of harmonization across diagnostic nosology systems informed the Future DSM Strategic Committee's development of the proposed diagnostic framework. Method The committee conducted literature reviews and held a series of meetings with experts across disciplines to gather their feedback, recommendations, and vision for the Future DSM. Results The main outcome of the Committee’s work is the development of a more holistic diagnostic model that moves beyond a purely categorical framework and improves clinical utility. Discussion & Conclusions In this session, the proposed diagnostic model for restructuring the DSM will be discussed. This proposed framework introduces transdiagnostic symptom dimensions that span multiple domains and cut across diagnoses. It also promotes the inclusion of emerging biomarkers, biological factors, and contextual factors. The presentation will also highlight how the model addresses harmonization with the ICD-11, HiTOP, and RDoC frameworks, thereby improving coherence across research, regulatory, and clinical domains. It will emphasize how diagnostic modernization can maintain usability for clinicians and researchers while improving alignment with real-world patient experiences.