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Angststörungen im DSM-5

Ein Überblick über Änderungen in Struktur und Inhalt

Anxiety disorders in DSM-5

An overview on changes in structure and content

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Zusammenfassung

Die DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) Arbeitsgruppe „Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders“ befasste sich mit der Rekonzeptualisierung aller angstassoziierten Störungen. Basierend auf systematischen Literaturanalysen, der Reanalyse vorhandener Daten sowie der Bewertung der Ergebnisse vor dem Hintergrund der DSM-5-Prinzipien wurde das Störungsspektrum in separate Kategorien für die „klassischen Angststörungen“, trauma- und belastungsbezogenen Störungen, Zwangsstörungen und verwandte Störungen sowie dissoziativen Störungen gegliedert. Unter den „klassischen Angststörungen“ werden nun auch der selektive Mutismus und die Störung mit Trennungsangst gruppiert. Eine wesentliche Änderung im DSM-5 gegenüber dem DSM-IV betrifft die vereinfachte Klassifikation der Panikstörung und der Agoraphobie, welche nunmehr separat kodiert werden; ihre Überlappung wird als komorbide Doppeldiagnose ausgewiesen. Die Angststörungskriterien wurden insgesamt hinsichtlich Inhalt und Reihenfolge sowie deren Anwendbarkeit auf alle Alters-, Geschlechts- und Kulturgruppen hin vereinheitlicht. Zudem wurden diagnosenspezifische und diagnosenübergreifende dimensionale Angstskalen entwickelt, welche die kategoriale Diagnostik insbesondere bei der Beurteilung des Schweregrades und des Therapieverlaufs ergänzen können.

Summary

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) “anxiety, obsessive-compulsive spectrum, posttraumatic, and dissociative disorders” work group addressed reconceptualization issues regarding all anxiety-related disorders. Based on systematic literature reviews, reanalyses of available data and evaluation of results following the DSM-5 principles it was decided to rearrange the disorder spectrum into separate groupings for the classical anxiety disorders, trauma- and stressor-related disorders, obsessive-compulsive and related disorders, and dissociative disorders. Among the classical anxiety disorders DSM-5 now also includes selective mutism and separation anxiety disorder. A major change from DSM-IV is a drastically simplified classification of panic disorder and agoraphobia. Both conditions can be separately coded in DSM-5 and the overlap is disclosed by a comorbid double diagnosis. The anxiety disorder criteria have been generally harmonized regarding content and order. It was assured that criteria are applicable to all age, gender and cultural groups. Furthermore, diagnosis-specific and cross-cutting dimensional anxiety scales have been developed to supplement categorical diagnosis which appears to facilitate assessment of severity and course of treatment.

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Abb. 1

Notes

  1. Mitglieder der „Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders“ Work Group waren: Katharine A. Phillips, M.D., Brown University; Gavin Andrews, M.D., University of New South Wales; Susan M. Bögels, Ph.D., University of Amsterdam; Michelle Craske, Ph.D., University of California, Los Angeles; Matthew J. Friedman, M.D., Ph.D., Dartmouth University; Roberto Lewis-Fernández, M.D., M.T.S., Columbia University; Robert Pynoos, M.D., M.P.H., University of California, Los Angeles; Scott L. Rauch, M.D., McLean Hospital; H. Blair Simpson, M.D., Ph.D., Columbia University; David Spiegel, M.D., Stanford University; Dan J. Stein, M.D., Ph.D., University of Cape Town; Murray B. Stein, M.D., University of California San Diego; Robert J. Ursano, M.D., Uniformed Services University; Hans Ulrich Wittchen, Ph.D., Technische Universität Dresden, Germany.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H.-U. Wittchen, I. Heinig und K. Beesdo-Baum geben an, dass keine Interessenkonflikte bestehen. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Institut für Klinische Psychologie und Psychotherapie & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Deutschland

    H.-U. Wittchen, I. Heinig & K. Beesdo-Baum

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  1. H.-U. Wittchen
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  2. I. Heinig
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  3. K. Beesdo-Baum
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Correspondence to H.-U. Wittchen.

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Wittchen, HU., Heinig, I. & Beesdo-Baum, K. Angststörungen im DSM-5 . Nervenarzt 85, 548–552 (2014). https://doi.org/10.1007/s00115-013-3986-2

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  • DOI: https://doi.org/10.1007/s00115-013-3986-2

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