In the first direct comparison of the DSM-5 PTSD diagnostic criteria and the prior DSM-IV-TR, researchers have called into question the accuracy of the criteria. After comparing these in US infantry soldiers, including many soldiers who served in Iraq and Afghanistan, there was a substantial discordance between the two diagnostic criteria.
These findings, “raise fundamental concerns as to whether changing the PTSD definition (a definition proven to be highly useful in guiding treatment for more than 25 years) will enhance diagnosis and clinical care, and what this means for current and future generations of veterans,” say researchers.
For the study, led by Charles Hoge, MD, senior scientist at the Center for Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, researchers compared the DSM-5 and DSM-IV-TR PTSD diagnostic criteria in 1,822 US infantry soldiers, including 946 who had served in Iraq and Afghanistan. They found the DSM-5 criteria did not match the DSM-IV-TR, “a conclusion based on nearly identical overlap with other psychiatric disorders and functional impairment.”
Nearly 30 percent of the soldiers who were diagnosed with PTSD under the DSM-IV-TR, did not meet the criteria in the DSM-5. “Clinicians need to consider how to manage discordant outcomes, particularly for service members and veterans with PTSD who no longer meet criteria under DSM-5,” the researchers conclude.