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Originalarbeiten/Original articles

DSM-5 Kommentar: Zwangsstörungen im DSM-5

Was ist neu?

Published Online:February 26, 2014https://doi.org/10.1024/1422-4917/a000279

Abstract

Zwangsstörungen sind auch im Kindes- und Jugendalter häufige und beeinträchtigende Erkrankungen. Die vorliegende Arbeit fasst die Änderungen von DSM-IV-TR Kriterien zu DSM-5 zusammen und unterzieht diese einer kritischen Würdigung. Zentral sind Änderungen der kategorialen Zuordnung, Zwänge sind nun nicht mehr der Kategorie Angststörungen zugeordnet, sondern repräsentieren eine eigenständige Kategorie, die aber dafür ein weiter gespanntes Zwangsspektrum umfasst. Neben kleineren deskriptiven Änderungen der Kriterien wird die klinische Einschätzung der Einsichtsfähigkeit (gut, schlecht, fehlend) gefordert. Die Zwangsstörung, die komorbid mit Ticstörungen einhergeht, wird als eigener Subtyp klassifiziert. Die Änderungen werden im Folgenden auf Basis der Studienlage und Literatur diskutiert, danach folgt ein Ausblick hinsichtlich der Umsetzung der neuen Kriterien auf den klinischen Alltag und die Forschung.


Obsessive-compulsive disorders in DSM-5 – what is new?

Obsessive-compulsive disorders are a frequent and debilitating condition also in children and adolescents. The present paper summarizes the changes in the DSM diagnostic criteria between the IV-TR edition and the DSM-5 edition, and evaluates them critically. A central feature is the revision of the category to which these disorders belong: Obsessive-Compulsive Disorders are no longer considered to be anxiety disorders, but rather now comprise an independent category encompassing a broader spectrum of obsessive-compulsive and related disorders. Minor changes have been made to the description of the criteria, and there is a new emphasis on the clinical assessment of the patient’s insight level (good, poor, absent). Obsessive-compulsive disorders associated with tic disorders are classified as a separate subtype. The present paper discusses these changes on the basis of the available studies and literature, and then looks ahead to the implementation of the new criteria in the everyday clinical setting and in research.

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