Diagnostic and Statistical Manual of Mental Disorders

Historical Background of the DSM

The DSM is one of the most significant texts used in the field of mental health, impacting clinical practice, research, and education worldwide. The DSM is used to classify mental disorders by providing criterion sets for each mental disorder as well as assigning codes to various diagnoses. The DSM has been in existence since the publication of the first edition in 1952. Since that time, it has undergone five revisions: the DSM-II published in 1968, the DSM-III published in 1980, a revision of the DSM-III (DSM-III-R) published in 1987, the DSM-TV published in 1994, and finally, the current text revision, the DSM-IV-TR, published in 2000.

Throughout the development of the DSM, changes and additions were made to reflect the state of knowledge regarding mental disease. Leading up to the creation of the first DSM, there was a need to gather statistical data on mental illnesses as was shown through the 1840 census, which recorded the frequency of "idiocy/insanity" Categories of mental illness continued to increase in number as knowledge in the field expanded. In the beginning of the 20th century, the focus shifted from the collection of statistical information to the development of diagnostic criteria. This occurred when the New York Academy of Medicine and the American Psychiatric Association came together and developed a text used to diagnose patients with neurological and psychiatric disorders known as the American Medical Association's Standard Classified Nomenclature of Disease.

According to the DSM-IV-TR, the area of mental health was largely influenced by World War II and by the U.S. Army to account for veterans who came back with various acute disorders, broadening the scope of diagnoses. Around the same time, the sixth edition of the ICD (ICD-6), published by the World Health Organization, also had a considerable impact on the development of the first DSM. The publication of the ICD-6 included a portion for mental disorders providing multiple categories for psychoneuroses and psychoses, as well as behavioral, character, and intelligence disorders. A variation of this section of the ICD-6 was then adapted by the American Psychiatric Association Committee on Nomenclature and Statistics in 1952 and became the first publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I). The first edition of the DSM lent itself to clinical use more than any other mental health text before it. At the time, the term reaction was used throughout the text, referring to Adolf Meyer's view that mental disorders were primarily the result of the patients' personality reacting to social, biological, and psychological factors. This term was eliminated with the publication of the DSM-II.

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