Changes in DSM

The DSM was first published by the APA in 1952 an has over the years gained acceptance and usage in the US and in other areas around the globe (Eriksen & Kress, 2005). The DSM coding system just like any other social idea has attracted both criticism and praise in all four versions that have been developed up to now. The DSM evolved out of a system of collecting information and statistics on psychiatric disorder which was developed by the US army. Development of DSM are continuous and have over the year kept in touch with improvement in medical and psychiatric field.

The development of the DSM can be traced back to 1917 when APA developed a statistical manual for the insane (Eriksen & Kress, 2005). This manual was developed through consultations with other psychiatric and medical bodies that led to a number of revisions. The medical 203 scheme was developed as a result of increased participations of the US soldiers in analysis and assessment of US soldiers (Eriksen & Kress, 2005). DSM-I is basically a revision of medical 203 that abandoned the basic outline and tried to express what resembles the present day perception of mental disturbance.

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DSM-I was a 130 page documents which contained 106 mental disturbances. The second version of the DSM, DSM-II was published in 1968 in a 134 page document that included 182 disorders. A notable difference with DSM-I is the drop of the term reaction though neurosis was maintained. Both versions reflected psycho-dynamics of mental disorders though they also used Kraepelin classification system where symptoms were not detailed for specific disorders.

Revisions of DSM-II that led to the development of the DSM-III were aimed at improving uniformity in diagnosis of mental disorders after DSM-II came under heavy criticism. The Rosenhan experiment led to controversy and realization on the need for standardizing diagnosis. Formulation of DSM-III was a controversial affair especially the deletion of neurosis and inclusion of the term disorder which led to criticism from even political circles. In 1980, DSM-III was released in a 494 page document which listed 265 diagnostic categories.

This version of DSM was revised in 1989 by reorganization and change in criteria (Eriksen & Kress, 2005). Some categories were deleted while others added, for instance the controversial premenstrual dysphoric disorder was discarded. The resultant was entitled DSM-III-R which was contained in a 567 page document that had 292 diagnoses (Eriksen & Kress, 2005). DSM-IV was brought out in 1994 in a 886 page document that contained 297 disorders.

One of the notable development made by DSM-IV is the inclusion of clinical significance criteria in half of categories which were in need of symptomatic cause (Eriksen & Kress, 2005). DSM-IV-TR is the most recent coding system and is basically a revision of DSM-IV. This coding system was published in 2000 and had no major changes on specific criteria for diagnosis. Text sections were added to give extra information and some codes updated to ensure consistency with the ICD coding system.