Psychiatric Diagnosis 10 Years After the Publication of DSM-5: Update of its Impact on the Legal System

Ten years after the adoption of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and with the recent publication of a text revision (DSM-5-TR), the limitations of this system for diagnostic classification of mental disorders remain. However, given that the alternatives that have been proposed have their own serious problems, DSM is likely to be retained for some time to come. It is generally accepted by courts as reflecting expert opinion. This paper highlights problems with the reliability and validity of DSM diagnoses, the tendency to overdiagnosis of certain categories, leading to problems with the use of these criteria in the courts, both in criminal and civil laws. The review argues that the categories in the DSM should be considered heuristics, not as disease entities equivalent to medical diagnoses supported by biomarkers and endophenotypes.