Washington, D.C. — The American Psychiatric Association (APA) has released a series of papers offering a proposed roadmap for the future of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The papers are authored by members of the Future DSM Strategic Committee, chaired by Maria Oquendo, M.D., Ph.D., chair of psychiatry at the University of Pennsylvania Perelman School of Medicine, and published online in the American Journal of Psychiatry.

The five papers, including the Initial Strategy for the Future of the DSM and four accompanying commentaries, are the result of the committee’s year of structured debate and consideration of long-standing critiques and rapid scientific advances. They propose a forward-looking model for the evolution of the DSM. They also suggest changing the name from Diagnostic and Statistical Manual to Diagnostic and Scientific Manual to better reflect its scientific and global scope. The four accompanying papers address structure and dimensions of the DSM; the role of biomarkers and biological factors in diagnosis; vision for incorporating socioeconomic, cultural and environmental determinants of health and intersectionality; and the role of functioning and quality of life in psychiatric diagnosis.

“We are pleased to share this forward-looking vision for the DSM, a culmination of extensive work of the Future DSM Strategic Committee and contributions of many others,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “The goal is to advance scientific rigor, cultural inclusivity, and adaptability while ensuring that the DSM remains useful to clinicians and remains a trusted, relevant tool for understanding and treating mental disorders.”

The four commentaries include:

The Future of DSM: A Report from the Structure and Dimensions Subcommittee

This paper from the Structure and Dimensions Subcommittee suggests a more flexible DSM structure that organizes assessment into four parts: (1) contextual factors, such as measures of socioeconomic, cultural, and environmental determinants of health, functioning, quality-of-life, and developmental and lifespan factors; (2) biomarkers and biological factors; (3) diagnoses that allow for different levels of specificity and severity; and (4) transdiagnostic features including symptoms that occur across many conditions.

The Future of DSM: Are Functioning and Quality of Life Essential Elements of a Complete Psychiatric Diagnosis?

The authors consider the role of functioning, how symptoms interfere with work, daily activities and relationships, and quality of life, how satisfied people feel with their physical, emotional and social well-being. They propose using brief, free, and practical tools to incorporate quality of life and functioning as part of a complete diagnosis.

The Future of DSM: A Strategic Vision for Incorporating Socioeconomic, Cultural, and Environmental Determinants of Health and Intersectionality

This paper looks at how life circumstances, including socioeconomic, cultural, and environmental determinants of health (SCE-DoH) and their intersection impact risk, resilience, symptoms, and recovery. The authors suggest that these aspects of lived experiences be systematically incorporated into assessment and treatment planning.

The Future of DSM: Role of Candidate Biomarkers and Biological Factors

The Biomarkers and Biological Factors Subcommittee reviewed advances in genetics, brain imaging, blood-based inflammation markers, and digital data from devices like wearables, which are beginning to reveal meaningful biological patterns that cut across traditional diagnoses. The authors propose a structured, dynamic process to integrate emerging knowledge about biological factors into the DSM, ultimately providing biologically grounded diagnostic categories.

The Future DSM Strategic Committee, which was established by the APA Board of Directors in 2024, includes vice chairs Jonathan E. Alpert, M.D., Ph.D., chair of psychiatry and behavioral sciences at Albert Einstein Medical School, and Nitin Gogtay, M.D., APA Deputy Medical Director and Vice President, Division of Research, and 14 voting members, along with nonvoting members and consultants.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 39,200 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.