Article

DSM-III and the revolution in the classification of mental illness

University of Richmond, Department of Political Science, USA.
Journal of the History of the Behavioral Sciences (Impact Factor: 0.79). 02/2005; 41(3):249-67. DOI: 10.1002/jhbs.20103
Source: PubMed

ABSTRACT

A revolution occurred within the psychiatric profession in the early 1980s that rapidly transformed the theory and practice of mental health in the United States. In a very short period of time, mental illnesses were transformed from broad, etiologically defined entities that were continuous with normality to symptom-based, categorical diseases. The third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) was responsible for this change. The paradigm shift in mental health diagnosis in the DSM-III was neither a product of growing scientific knowledge nor of increasing medicalization. Instead, its symptom-based diagnoses reflect a growing standardization of psychiatric diagnoses. This standardization was the product of many factors, including: (1) professional politics within the mental health community, (2) increased government involvement in mental health research and policymaking, (3) mounting pressure on psychiatrists from health insurers to demonstrate the effectiveness of their practices, and (4) the necessity of pharmaceutical companies to market their products to treat specific diseases. This article endeavors to explain the origins of DSM-III, the political struggles that generated it, and its long-term consequences for clinical diagnosis and treatment of mental disorders in the United States.

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Available from: Rick Mayes, Mar 13, 2014
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    • "Epistemic in the sense that it was related to a specifically desired way to structure knowledge (i.e., scientifically). Political in the sense that by aligning psychiatry with other medical specialties that perform preventive interventions it would improve the medical status of psychiatric field, a position questioned from time to time in the history of the specialty[32]by those who consider it scientifically underdevel- oped[3]. Both researchers and Work Group members were committed to the value of scientific development. "
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    • "Women, too, have long been denied equal opportunities based on their supposed physical and mental deficiencies (Reed 1978; Schur 1984). Likewise, homosexuality was classified as a mental disorder by the American Psychiatric Association until 1973, thus legitimizing any number of medical 'interventions' on homosexual patients (Mayes and Horwitz 2005). Medicalization has been a powerful tool of social control, and this control, we argue, extends into the social movement arena. "
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    • "En su primera edición (de corte psicoanalítico) se incluían 106 trastornos, en la edición siguiente, de 1968, 137. En 1980, el DSM III inauguró el uso del diagnóstico categorial basado en los síntomas para definir los trastornos mentales (Mayes y Horwitz, 2005); el número de trastornos aumentó hasta 182. En el último DSM, el 5, publicado en 2013, el número es 216. "
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