Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders (DSM),
(dī'ag-nos'tic stă-tis'ti-kăl man'yū-ăl men'tăl dis-or'dĕrz),The first edition (1952), based on the sixth revision of the International Classification of Diseases (ICD-6), was intended to promote uniformity in the naming and reporting of psychiatric disorders. It contained definitions of all named disorders, but no sets of diagnostic criteria. Although its classification of mental disorders showed the influence of freudian psychoanalysis, its nomenclature (for example, depressive reaction, anxiety reaction, schizophrenic reaction) reflected the theories of Adolf Meyer (1866-1950). The second edition (DSM-II, 1968) preserved the psychoanalytic orientation but dropped the "reaction" terminology. The third edition (DSM-III, 1980) abandoned much of the rigidly psychodynamic thinking of the earlier editions and, for the first time, provided explicit diagnostic criteria and introduced a multiaxial system whereby different aspects of a patient's condition could be separately assessed. Briefly stated, the axes are I, clinical disorders; II, personality disorders and mental retardation; III, general medical disorders; IV, psychosocial and environmental stressors; and V, overall level of functioning. A revised version of the third edition (DSM-IIIR, 1987) incorporated improvements and clarifications. The fourth edition (DSM-IV) appeared in May, 1994. It follows its two predecessors closely in general outline, and like them is coordinated with and partly derived from ICD-9. For many observers, the most significant change in DSM-IV is the renaming of the category formerly called Organic Mental Syndromes and Disorders as Delirium, Dementia, and Amnestic and Other Cognitive Disorders, a shift in terminology intended to avoid the implication that mental disorders in other categories are not organic.