The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) was published by the American Psychiatric Association in 1994. The DSM-IV became obsolete when the DSM-IV-TR was published in 2000. The “TR” in DSM-IV-TR stands for Text Revision. Most recently, in May, 2013, the DSM-5 was published. While many of the diagnoses and the diagnostic criteria for disorders have remained the same with each revision of the DSM, substantial differences definitely exist between the manuals. Typically, many of the substantial differences are outlined on multiple pages in the later sections of the manuals. Moreover, when you are reading a psych report, find the area in the report where the doctor stated which version of the DSM they used in arriving at their diagnostic conclusions. When doing so, if it becomes clear that the doctor simultaneously used two different versions of the DSM in evaluating the patient and producing their report you should question the doctor about that substantial flaw on cross-examination.