Smart Updates for a Living Document: The DSM-5

A revision history with easy-to-identify updates for a world-renowned reference manual


The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition—commonly known as the DSM-5—is the definitive classification of mental illnesses. Precisely defining these disorders with standardized diagnosis criteria allows medical and mental health professionals, health insurers, and lawyers to speak a common language and helps ensure that patients receive the care they need. The DSM-5 is part of, the Association’s portal for psychiatric reference publications. It has been hosted on Literatum, Atypon’s online publishing platform, since 2015.


To ensure the manual’s continued relevance, the American Psychiatric Association (APA) has an appointed committee of experts to evaluate the DSM-5. Periodic updates are approved and then published via PDF. Because even minor changes can have far-reaching medical and financial implications, APA Publications approached Atypon for a way to easily track and compare these changes and update the manual’s online version on a continual basis.


Atypon designed and engineered a sophisticated XML-based solution for Literatum, with native support for the DSM-5’s proprietary DTD. It compares the previous and current versions of the manual, identifies every difference, and maintains a revision history of every change, including alterations to tables and complex figures. APA can preview and modify updates before the final XML is uploaded to Literatum.

Readers see every change in an easy-to-read pop-up box adjacent to the change that includes the revision date and supplementary information about the entry. The pop-up box scrolls alongside the online text and can be easily dismissed and reopened. The highlights and pop-up boxes appear automatically—no additional development or technical assistance is required.

Literatum also automatically harmonizes the manual’s index with all modifications. The deletions, which are maintained for the web-based version, are scrubbed so that clean revisions can be converted to compatible XML and uploaded to EBSCO, Crossref, and ProQuest.


The DSM-5 on never goes out of date, so medical professionals and other subscribers always have real-time access to the most up-to-date information available. The DSM also now serves as a scholarly tool for researchers interested in the evolution of how mental illnesses are classified.

By making the new functionality part of a premium product, the APA has increased the value of PsychiatryOnline for its subscribers, incentivized renewals, and attracted new customers. The DSM-5 is fast becoming a new standard for how other periodically updated online reference documents, clinical manuals, and standards of all kinds can be published.

“The DSM-5’s smart new interface is supported by complex technology that’s significantly improving the usefulness and value of our profession’s authoritative diagnostic manual. We believe it will become a new standard for all publishers of clinical manuals, practice guidelines, and any other reference documents that are updated periodically.”

Tim Marney, Director, Digital Publishing, American Psychiatric Association

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