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The American Psychiatric Association has approved a new edition of its Diagnostic and Statistical Manual for Mental Disorders (DSM-5) that combines substance abuse and dependence into a single category of “substance use and addictive disorders.” The DSM is the official guide to classifying psychiatric illness, according to The Wall Street Journal.

Currently, substance abuse is defined as short-term binging, while substance dependence is considered to be addiction, the article notes. The new spectrum of substance use and addictive disorders includes 11 specific symptoms. These include the inability to cut down or meet obligations at home or at work.

The spectrum’s severity will be judged based on how many criteria a patient meets. A person with two or three will be diagnosed with a mild disorder, while someone who meets six or more will be diagnosed with a more severe disorder. While supporters of the change say it will make it easier to spot problems earlier, some opponents say it could pathologize occasional binging.

The changes to the manual come after more than a decade of discussion and debate. They can affect who qualifies for subsidized services, insurance reimbursements and treatment programs.

Another major change in the DSM-5 is the combination of subcategories of autism, such as Asperger’s syndrome, into one category of autism spectrum disorder. The manual also creates a new diagnosis of disruptive mood dysregulation disorder, for children with frequent behavioral outbursts.

The new edition of the manual will be published next spring.


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