Is DSM-IV Needed at All?

To the Editor.— I wrote an article for the December 1988 issue of theArchivesin which I posed the question, "Why Are We Rushing to PublishDSM-IV?"1When I wrote that articleDSM-IVwas scheduled for publication in 1992, 5 years after theDSM-III-Rpublication date.2I delineated a number of problems that might result from the publication of a thirdDSMedition in 12 years. In brief, these problems are the following: (1) an insufficient amount of time betweenDSMeditions to allow the accumulation of replicated research necessary to justify a change in diagnostic criteria; (2) the expenditure of resources to compare the new diagnostic criteria with the old and thus reduce the effort toward discovering pathophysiologic mechanisms; (3) difficulties in interpreting and resolving discrepant research findings based on different criteria sets; (4) an increased number of diagnostic errors because of the lack of time