An overview of the DSM-5: changes, controversy, and implications for psychiatric nursing.

Scheduled for publication in May 2013, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), will guide clinical diagnoses, treatment plans, medication choices and protocols, insurance reimbursements, and research agendas throughout the United States. It will also serve as a reference manual for clinicians around the world. This primary diagnostic source used by psychiatric and mental health providers is undergoing significant change in organization and content relative to the previous edition. This article provides a general overview of what to expect in the DSM-5, highlighting major aspects of the revision. Included is a list of the proposed diagnostic categories and an overview of some of the debate and discussion accompanying the changes. Implications for psychiatric nurses and psychiatric nursing are presented.

DSM-5: historical perspectives.

The first major attempts to categorize psychiatric disorders in the United States occurred in the mid-1800s, when census data were collected that included "insanity" and "idiocy" of household members. In Europe, Florence Nightingale promoted the use of non-fatal disease classification for morbidity and treatment in 1860. By the late 1800s, Kraepelin categorized disorders, and his sixth edition of the Compendium der Psychiatrie was widely adopted by both Europeans and Americans. In 1952, the American Psychiatric Association published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Since then, the manual has been periodically updated, expanded, and edited to reflect social and scientific beliefs about the etiology and categorization of psychiatric illness and care. In this article, we explore the historical and ongoing development of the DSM and its implications for psychiatric nurses.

A signature wound of war: mild traumatic brain injury.

Improvised explosive devices are the weapons of choice for the insurgent enemy in Iraq and Afghanistan. More soldiers are surviving these blast injuries due to improved torso protection yet are sustaining head and neck wounds in numbers that exceed those from previous wars. Although moderate and severe traumatic head injuries are easily identified and aggressively treated, mild traumatic brain injuries (m-TBIs), or concussions, had previously been deemed inconsequential and often overlooked. Recently, however, the U.S. Department of Defense and Veterans Health Administration have placed emphasis on identifying service members at risk for m-TBI because a select number continue to have disabling symptoms that can negatively affect quality of life. Research regarding the effects and treatment of blasts injury are gaining momentum, but further work needs to be accomplished. This article provides a three-question screening tool that can be used to identify these at-risk veterans.

The experience of nursing students in an online doctoral program in nursing: a phenomenological study.

The increased sophistication of technology has led to greater use of distance learning, providing graduate nursing students with increased access to such programs, while more easily maintaining employment. Little information is available regarding the experience for those students enrolled on these programs. This information would be of value to both those who are considering online courses, and to those who are charged with developing and teaching these courses. A phenomenological approach was used in order to examine the experience of five students enrolled in an online doctoral program in nursing in the United States. Verbatim transcripts were analyzed for themes from which three main ones emerged as the essence of the experience: considering the fit, liking the fit, and making it fit. Recommendations are provided for future research pertaining to distance education, particularly in the form of graduate outcomes.

The stigma of seeking care and depression.

This study investigates the relationship between stigma and care-seeking for depression. One hundred-seventeen people in a primary care facility and an urban public health clinic completed the Attitudes Toward Seeking Professional Help Scale and the Attribution Questionnaire. The belief that depression was under personal control was associated with less receptivity toward seeking care, and greater anger toward the person with depression. Pity was associated with seeking professional care and with a desire to help. Dangerousness was unrelated to care-seeking. Gender and setting influenced the results-for men and urban respondents there was no relationship between responsibility and care-seeking.

Stigma in psychiatric nursing.

TOPIC: Stigmatizing attitudes in psychiatric nursing. PURPOSE: To develop a greater awareness of the existence of stigma associated with psychiatric nursing. SOURCES: Published literature. CONCLUSIONS: Professional self-understanding and knowledge are methods by which psychiatric nursing can elevate its professional image and value.