Neurocognitive diagnostic challenges and the DSM-5: perspectives from the front lines of clinical practice.

The proposed changes to the DSM-IV-TR are an attempt to advance a common language to be used by clinicians and researchers in psychiatry in the United States. Any improvement brought about by these changes may be jeopardized unless the ICD-10, which is used by non-psychiatric clinicians and researchers worldwide, and the DSM resolve the differences in the definitions and diagnostic criteria of most disorders. Unless there is congruence between the two manuals, debate is therefore likely to continue in the literature as to which provider is best suited to direct the care for the person with dementia: primary care providers, psychiatric providers, or neurologists. The changes to the DSM-IV-TR have the potential to promote preventive measures and early diagnosis, provided that the stigma associated with mental illnesses can be mitigated. A common language among psychiatric and primary care APRNs, other clinicians, and researchers will enhance effective communication and improve dementia care.