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History of the DSM

The Diagnostic and Statistical Manual of Mental Disorders is in its fourth edition. Thus,
the official title is the DSM IV. The most current version is also appended with the
letters TR -- DSM IV-TR. The "TR" stands for Text Revision. There were some revisions
and rewordings done to the original version IV to clarify and correct the text.
The first version of the DSM was produced by the American Psychiatric Association in
1952. That was the first official Manual (actually more of a glossary) of accepted mental,
emotional, psychological and psycho-biological disorders.
The second version of the DSM appeared in 1968. The most significant advancement in
this DSM version was that the mental disorders were integrated with the International
Classification of Diseases. Thus, this version allowed medical doctors (e.g. psychiatrists)
to include mental disorders as a medical condition for their patients.
The third edition of the DSM came about in 1987. The purpose of the DSM III edition
was to upgrade the knowledge base regarding psychological nomenclature to meet the
standards of the World Health Organization and the ICD-9.
The most recent edition of the DSM (version IV) was published in 2000. The DSM IV is
a response to the World Health Organization's updating of the International Statistical
Classification of Diseases and Related Health Problems version #10 (ICD 10). That
international classification of all disorders that face humans will go into effect in the
year 2004. The American Psychiatric Association has worked in tandem with the WHO
to uniformly classify all mental disorders within the context of the ICD-10
classifications. These new classifications will become the standard by which all
insurance companies accept diagnoses for individuals.
 

Contents of the DSM

Anyone who has never picked up the DSM IV-TR before and does so will probably spend
considerable time scratching their head. At first glance, the book looks ominously
confusing and technical. It is technical -- it is, after all, a sort of medical book. There is
no way for it not to be technical. It is not, however, as confusing as it first appears. The
authors have done well laying it out very logically.
The DSM IV contains a structured analysis and commentary with diagnostic criteria for
every mental, emotional and psychological disorder imaginable. The bulk of the DSM IV
book contains descriptions and diagnoses from Axis I and Axis II (the Axis system will
be explained shortly).
The bulk of that material is from Axis I. Axis I contains descriptions and diagnoses for
mental, emotional and psychological disorders. Axis II is the classification of personality disorders.
The Axis I material is broken down into logical categories. Those categories are all
contained in separate chapters that explicitly describe the disorders in that category.
Categories under Axis I include: Disorders usually first diagnosed in childhood;
delirium, dementia and other cognitive disorders; mental disorders due to medical
conditions; substance-related disorders; schizophrenia and psychotic disorders; mood
disorders; anxiety disorders; somatoform disorders; factitious disorders; dissociative
disorders; sexual disorders; eating disorders; sleep disorders; impulse control disorders;
and, adjustment disorders.
The pastoral counselor who scans through the list of categories found in the Axis I
classifications will undoubtedly see categories of disorders that they have dealt with in
real counseling situations. Thus, there is some validation of at least some of the content
of the DSM IV and, therefore, some reason for a pastoral counselor to gain a better
understanding of the whole volume.