COLUMNS: Law and PsychiatryThe DSM-5 and Forensic PsychiatryWORTZEL, HAL S. MD Author Information Hal S. Wortzel, MD, is the Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, an Assistant Professor in Psychiatry and Neurology, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado. He is Director of Neuropsychiatric Services for the VISN 19 Mental Illness Research, Education and Clinical Center at the Denver VA. Address inquiries to: [email protected] Journal of Psychiatric Practice: May 2013 - Volume 19 - Issue 3 - p 238-241 doi: 10.1097/01.pra.0000430508.44768.9d Buy Metrics Abstract In his first Law and Psychiatry column for the Journal of Psychiatric Practice, the author discusses potential forensic consequences of the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While the transition to DSM-5 may prove challenging for both patients and clinicians, the scrutiny and adversarial process associated with forensic psychiatric practice will entail a unique set of challenges. The philosophy of innovation behind the DSM-5, and the attendant changes, could lead to some unintended consequences, particularly in medicolegal settings. This column highlights some of the major changes in DSM-5 and explores points of particular concern for forensic psychiatric practice, such as the move toward a non-multiaxial diagnostic system and dimensional severity ratings being superimposed on certain categorical diagnoses. The innovative changes featured in DSM-5, and the controversies surrounding some of them, could yield an environment of increased cynicism in courts of law, with renewed skepticism regarding mental health diagnoses and the forensic psychiatrists who testify about them. Fortunately, the best method for forensic psychiatric practice in this environment of change is to continue to adhere to a meticulous and transparent medicolegal process, with recognition that changes in the diagnostic manual will seldom alter essential medicolegal conclusions. Forensic psychiatrists may enhance their credibility and the strength of the opinions they offer by proactively illustrating how nuances in diagnosis do not change legally defined constructs such as insanity or incompetence. (Journal of Psychiatric Practice 2013;19:238–241) Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.