Breaking Changes

This article draws a parallel between the DSM (Diagnostic and Statistical Manual of Mental Disorders) and software release practices, noting how the manual has evolved through versions and point releases, such as the DSM-5-TR. The author, a software professional, critiques how clinicians, insurers, and patients treat the versioned document as fixed truth, while the APA itself acknowledges its revisability. The concept of 'breaking changes' from software development is applied to the DSM, highlighting how changes like the depathologization of homosexuality in 1973 occurred without migration paths for affected individuals. The piece explores the tension between the document's statistical nature and its authoritative use in real-world settings.