The threshold for approval of a diagnosis in DSM-IV was more conservative, requiring more empirical backing. 

University of Illinois at Urbana-Champaign

Number

Threshold

Culture-specific aspect

Process

Changes from DSM-III

Sanders, J. L. (2011). A distinct language and a historic pendulum: the evolution of the Diagnostic and Statistical Manual of Mental Disorders. Archives of psychiatric nursing, 25(6), 394-403. https://doi.org/10.1016/j.apnu.2010.10.002

A distinct language and a historic pendulum: the evolution of the Diagnostic and Statistical Manual of Mental Disorders

The number of mental disorders increased from more than 200 in the DSM-III to more than 300 in the DSM-IV. 

Number

Threshold

DSM-IV emphasized more on culture-specific aspects of diagnosis, including new discussions of "cultural variation", all based on the assumption that the DSM-IV must be applicable cross culturally. 

Culture-specific aspect

The most significant changes in DSM-IV were in the revision process itself. The process was more systematic, obtaining and reviewing empirical input through literature review, data reanalyses, and field trials, so that decisions are based on evidence, not individual opinion. 

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