Edit count of the user (user_editcount) | null |
Name of the user account (user_name) | '71.95.101.227' |
Age of the user account (user_age) | 0 |
Groups (including implicit) the user is in (user_groups) | [
0 => '*'
] |
Rights that the user has (user_rights) | [
0 => 'createaccount',
1 => 'read',
2 => 'edit',
3 => 'createtalk',
4 => 'writeapi',
5 => 'viewmyprivateinfo',
6 => 'editmyprivateinfo',
7 => 'editmyoptions',
8 => 'abusefilter-log-detail',
9 => 'urlshortener-create-url',
10 => 'centralauth-merge',
11 => 'abusefilter-view',
12 => 'abusefilter-log',
13 => 'vipsscaler-test'
] |
Whether or not a user is editing through the mobile interface (user_mobile) | false |
Whether the user is editing from mobile app (user_app) | false |
Page ID (page_id) | 8498 |
Page namespace (page_namespace) | 0 |
Page title without namespace (page_title) | 'Diagnostic and Statistical Manual of Mental Disorders' |
Full page title (page_prefixedtitle) | 'Diagnostic and Statistical Manual of Mental Disorders' |
Edit protection level of the page (page_restrictions_edit) | [] |
Last ten users to contribute to the page (page_recent_contributors) | [
0 => 'Certes',
1 => 'Citation bot',
2 => 'Klrgmclass',
3 => 'Kindly Copyeditor',
4 => '2600:1700:9EE0:F5F0:1511:A748:4729:F3B6',
5 => 'Beland',
6 => 'AnomieBOT',
7 => 'Philroc',
8 => 'Comp.arch',
9 => 'DocWatson42'
] |
Page age in seconds (page_age) | 712922465 |
Action (action) | 'edit' |
Edit summary/reason (summary) | '/* DSM-IV Categorization */ ' |
Time since last page edit in seconds (page_last_edit_age) | 20357 |
Old content model (old_content_model) | 'wikitext' |
New content model (new_content_model) | 'wikitext' |
Old page wikitext, before the edit (old_wikitext) | '{{Short description|American psychiatric classification}}
{{Use mdy dates|date=February 2024}} {{Use American English|date=February 2024}}
[[File:DiagnosticAndStatisticalManualOfMentalDisorders.jpg|thumb|1952 edition of the DSM (DSM-I)]]
The '''''Diagnostic and Statistical Manual of Mental Disorders''''' ('''''DSM'''''; latest edition: ''[[DSM-5-TR]]'', published in March 2022<ref name=":1">{{Cite web|title=DSM-5 Full Text Online|url=http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf|access-date=10 January 2022|via=Archive.Today}}</ref>) is a publication by the [[American Psychiatric Association]] (APA) for the [[classification of mental disorders]] using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the [[United States]] and [[Australia]],<ref>{{Cite web |date=2021-04-30 |title=How Australia adopted America's bible of psychiatry |url=https://www.afr.com/policy/health-and-education/how-australia-adopted-america-s-bible-of-psychiatry-20210419-p57kjr |access-date=2024-01-24 |website=Australian Financial Review |language=en}}</ref> while in other countries it may be used in conjunction with other documents. The DSM-5 is considered one of the principal guides of psychiatry, along with the [[International Classification of Diseases]] (ICD), [[Chinese Classification of Mental Disorders]] (CCMD), and the ''[[Psychodynamic Diagnostic Manual]]''. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world<ref name ="Do mental health professionals use diagnostic classifications the way we think they do? A global survey">{{Cite journal|vauthors=First M, Rebello T, Keeley J, Bhargava R, Dai Y, Kulygina M, Matsumoto C, Robles R, Stona A, Reed G |title=Do mental health professionals use diagnostic classifications the way we think they do? A global survey|journal=World Psychiatry|language=en|volume=17|issue=2|pages=187–195|pmid = 29856559| date = June 2018 | doi=10.1002/wps.20525|pmc=5980454 }}</ref> and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.<ref name = "Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis">{{Cite journal|vauthors = Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JP, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JP, Geddes JR | title = Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis | journal = The Lancet | date = 7 April 2018 | volume = 391 | issue = 10128 | pages = 1357–1366 | doi = 10.1016/S0140-6736(17)32802-7 | pmid = 29477251 | pmc = 5889788 }}</ref><ref>{{cite journal | vauthors=Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D | journal=International Clinical Psychopharmacology | title=Efficacy of treatments for anxiety disorders: a meta-analysis | volume=30 | issue=4 | pages=183–192 | date= July 2015 | issn=0268-1315 | doi=10.1097/YIC.0000000000000078| pmid=25932596 | s2cid=24088074 }}</ref><ref>{{cite journal | vauthors=Schneider-Thoma J, Chalkou K, Dörries C, Bighelli I, Ceraso A, Huhn M, Siafis S, Davis JM, Cipriani A, Furukawa TA, Salanti G, Leucht S | journal=Lancet | title=Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis | volume=399 | issue=10327 | date=26 February 2022 | pages=824–836 | issn=0140-6736 | doi=10.1016/S0140-6736(21)01997-8 | pmid=35219395 | s2cid=247087411 | doi-access=free }}</ref><ref>{{cite journal | vauthors=Gartlehner G, Crotty K, Kennedy S, Edlund MJ, Ali R, Siddiqui M, Fortman R, Wines R, Persad E, Viswanathan M | journal=CNS Drugs | title=Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis | volume=35 | issue=10 | pages=1053–1067 | date= October 2021 | issn=1172-7047 | doi=10.1007/s40263-021-00855-4| pmid=34495494 | pmc=8478737 }}</ref>
It is used by researchers, [[psychiatric drug]] regulation agencies, [[health insurance]] companies, [[pharmaceutical companies]], the legal system, and policymakers. Some mental health professionals use the manual to determine and help communicate a patient's diagnosis after an evaluation. Hospitals, clinics, and insurance companies in the United States may require a DSM diagnosis for all patients with mental disorders. Health-care researchers use the DSM to categorize patients for research purposes.
The DSM evolved from systems for collecting census and [[psychiatric hospital]] statistics, as well as from a [[United States Army]] manual. Revisions since its first publication in 1952 have incrementally added to the total number of [[mental disorders]], while removing those no longer considered to be mental disorders.
Recent editions of the DSM have received praise for standardizing psychiatric diagnosis grounded in empirical evidence, as opposed to the theory-bound [[nosology]] (the branch of [[medical science]] that deals with the [[Medical classification|classification of diseases]]) used in DSM-III.{{Citation needed|reason=Reads as more of a marketing statement than academically sound claim. A citation from the APA declaring itself to be an authority would not be sufficient backing for this claim.|date=April 2023}} However, it has also generated [[#Criticisms|controversy and criticism]], including ongoing questions concerning the [[Reliability (statistics)|reliability]] and [[Validity (statistics)|validity]] of many diagnoses; the use of arbitrary dividing lines between mental illness and "[[Normality (behavior)|normality]]"; possible [[cultural bias]]; and the [[medicalization]] of human distress.<ref name="frana">{{cite web |url=http://annals.org/article.aspx?articleid=1688399 |title=The New Crisis in Confidence in Psychiatric Diagnosis | vauthors = Frances A |date=17 May 2013 |work=Annals of Internal Medicine |author-link=Allen Frances }}</ref><ref name="concept&evolution">{{cite journal | vauthors = Dalal PK, Sivakumar T | title = Moving towards ICD-11 and DSM-V: Concept and evolution of psychiatric classification | journal = Indian Journal of Psychiatry | volume = 51 | issue = 4 | pages = 310–319 | year = 2009 | pmid = 20048461 | pmc = 2802383 | doi = 10.4103/0019-5545.58302 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Kendell R, Jablensky A | title = Distinguishing between the validity and utility of psychiatric diagnoses | journal = The American Journal of Psychiatry | volume = 160 | issue = 1 | pages = 4–12 | date = January 2003 | pmid = 12505793 | doi = 10.1176/appi.ajp.160.1.4 | s2cid = 16151623 }}</ref><ref>{{cite journal | vauthors = Baca-Garcia E, Perez-Rodriguez MM, Basurte-Villamor I, Fernandez del Moral AL, Jimenez-Arriero MA, Gonzalez de Rivera JL, Saiz-Ruiz J, Oquendo MA | display-authors = 6 | title = Diagnostic stability of psychiatric disorders in clinical practice | journal = The British Journal of Psychiatry | volume = 190 | issue = 3 | pages = 210–216 | date = March 2007 | pmid = 17329740 | doi = 10.1192/bjp.bp.106.024026 | s2cid = 4888348 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Pincus HA, Zarin DA, First M | title = 'Clinical significance' and DSM-IV | journal = Archives of General Psychiatry | volume = 55 | issue = 12 | pages = 1145; author reply 1147–1145; author reply 1148 | date = December 1998 | pmid = 9862559 | doi = 10.1001/archpsyc.55.12.1145 | url = http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145 | archive-url = https://web.archive.org/web/20070929134334/http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145 | archive-date = 2007-09-29 }}</ref> The APA itself has published that the inter-rater reliability is low for many disorders in the DSM-5, including [[major depressive disorder]] and [[generalized anxiety disorder]].<ref name ="DSM-5 Field Trials in the United States and Canada, Part II: Test-Retest Reliability of Selected Categorical Diagnoses">{{Cite journal | vauthors = Regier D, Narrow W, Clarke D, Kraemer H, Kuramoto S, Kuhl E, Kupfer D|title=DSM-5 Field Trials in the United States and Canada, Part II: Test-Retest Reliability of Selected Categorical Diagnoses|journal=American Journal of Psychiatry|volume=170|issue=1|pages=59–70|doi=10.1176/appi.ajp.2012.12070999|year=2013|pmid=23111466 }}</ref>
==Distinction from ICD==
An alternate, widely used classification publication is the ''[[International Statistical Classification of Diseases and Related Health Problems|International Classification of Diseases]]'' (ICD) is produced by the [[World Health Organization]] (WHO).<ref>''[[ICD-10|ICD-10 Classification of Mental and Behavioural Disorders]]:''
"[https://www.who.int/classifications/icd/en/bluebook.pdf Clinical descriptions and diagnostic guidelines]" (aka the "Blue Book"); and
"[https://www.who.int/classifications/icd/en/GRNBOOK.pdf Diagnostic criteria for research]" (aka the "Green Book").</ref> The ICD has a broader scope than the DSM, covering overall health as well as mental health; chapter 5 of the ICD specifically covers mental and behavioral disorders. Moreover, while the DSM is the most popular diagnostic system for mental disorders in the US, the ICD is used more widely in Europe and other parts of the world, giving it a far larger reach than the DSM. An international survey of psychiatrists in sixty-six countries compared the use of the [[ICD-10]] and DSM-IV. It found the former was more often used for clinical diagnosis while the latter was more valued for research.<ref>{{cite journal |vauthors=Mezzich JE |year=2002 |title=International surveys on the use of ICD-10 and related diagnostic systems |journal=Psychopathology |volume=35 |issue=2–3 |pages=72–75 |doi=10.1159/000065122 |pmid=12145487 |s2cid=35857872}}</ref> This may be because the DSM tends to put more emphasis on clear diagnostic criteria, while the ICD tends to put more emphasis on clinician judgement and avoiding diagnostic criteria unless they are independently validated. That is, the ICD descriptions of psychiatric disorders tend to be more qualitative information, such as general descriptions of what various disorders tend to look like. The DSM focuses more on quantitative and operationalized criteria; e.g. to be diagnosed with X disorder, one must fulfill 5 of 9 criteria for at least 6 months.<ref name=":2">{{Cite journal |last=Tyrer |first=Peter |date=2014 |title=A comparison of DSM and ICD classifications of mental disorder |journal=Advances in Psychiatric Treatment |language=en |volume=20 |issue=4 |pages=280–285 |doi=10.1192/apt.bp.113.011296 |issn=1355-5146|doi-access=free }}</ref>
The [[DSM-IV-TR codes|DSM-IV-TR]] (4th ed.) contains specific codes allowing comparisons between the DSM and the ICD manuals, which may not systematically match because revisions are not simultaneously coordinated.<ref>In Appendix G: "ICD-9-CM Codes for Selected General Medical Conditions and Medication-Induced Disorders"</ref> Though recent editions of the DSM and ICD have become more similar due to collaborative agreements, each one contains information absent from the other.<ref>{{cite journal | author = American Psychological Association | year = 2009 | title = ICD VS. DSM | url = http://www.apa.org/monitor/2009/10/icd-dsm.aspx | journal = Monitor on Psychology | volume = 40 | issue = 9|page = 63 }}</ref> For instance, the two manuals contain overlapping but substantially different lists of recognized [[culture-bound syndrome]]s.<ref>[https://www.who.int/entity/classifications/icd/en/GRNBOOK.pdf Diagnostic criteria for research], p. 213–225 ([[World Health Organization|WHO]] 1993)</ref> The ICD also tends to focus more on primary-care and low and middle-income countries, as opposed to the DSM's focus on secondary psychiatric care in high-income countries.<ref name=":2" />
==Antecedents (1840–1949)==
===Census Office, AMA and ISI (1840–1911)===
The initial impetus for developing a classification of mental disorders in the United States was the need to collect statistical information. The first official attempt was the [[United States census, 1840|1840 census]], which used a single category: "[[idiocy]]/[[insanity]]". Three years later, the [[American Statistical Association]] made an official protest to the [[U.S. House of Representatives]], stating that "the most glaring and remarkable errors are found in the statements respecting [[nosology]], prevalence of insanity, blindness, deafness, and dumbness, among the people of this nation", pointing out that in many towns [[African Americans]] were all marked as insane, and calling the statistics essentially useless.<ref>{{cite journal | vauthors = Gorwitz K | title = Census enumeration of the mentally ill and the mentally retarded in the nineteenth century | journal = Health Services Reports | volume = 89 | issue = 2 | pages = 180–187 | date = March–April 1974 | pmid = 4274650 | pmc = 1616226 | doi = 10.2307/4595007 | jstor = 4595007 }}</ref>
The [[Association of Medical Superintendents of American Institutions for the Insane]] ("The Superintendents' Association") was formed in 1844.<ref>{{Cite journal |date=1976 |title=The original thirteen |journal=Hospital & Community Psychiatry |volume=27 |issue=7 |pages=464–467 |issn=0022-1597 |pmid=776775}}</ref>
In 1860, during the international statistical congress held in London, [[Florence Nightingale]] made a proposal that was to result in the development of the first international model of systematic collection of hospital data.
In 1872, the [[American Medical Association]] (AMA) published its ''Nomenclature of Diseases'', which included various "Disorders of the Intellect".<ref>{{Cite web |title=A nomenclature of diseases: with the reports of the majority and of the minority of the committee thereon: presented to the American Medical Association at the meeting held in Philadelphia, May 1872 |url=https://collections.nlm.nih.gov/catalog/nlm:nlmuid-31910070R-bk |access-date=2022-11-06 |website=Digital Collections – National Library of Medicine |page=53}}</ref> Its use was short-lived however.<ref>{{Cite book |url=https://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf |archive-url=https://web.archive.org/web/20110505192204/http://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf |archive-date=2011-05-05 |url-status=live |title=History of the Statistical Classification of Diseases and Causes of Death |publisher=National Centre for Health Statistics |year=2011}}</ref>
Edward Jarvis and later [[Francis Amasa Walker]] helped expand the census, from two volumes in 1870 to twenty-five volumes in 1880.<ref>{{Cite journal |vauthors=Grob GN |date=1976 |title=Edward Jarvis and the Federal Census: A Chapter in the History of Nineteenth-Century American Medicine |journal=Bulletin of the History of Medicine |publisher=The Johns Hopkins University Press |volume=50 |issue=1 |pages=4–27 |jstor=44450311 |pmid=769874 }}</ref>
In 1888, the [[United States Census Bureau|Census Office]] published Frederick H. Wines' 582-page volume called ''Report on the Defective, Dependent, and Delinquent Classes of the Population of the United States, As Returned at the Tenth Census (June 1, 1880)''. Wines used seven categories of mental illness, which were also adopted by the Superintendents: [[dementia]], [[dipsomania]] (uncontrollable craving for alcohol), [[epilepsy]], [[mania]], [[melancholia]], [[monomania]], and [[paresis]].<ref>[https://sites.google.com/site/psych54000/a History of the DSM] {{Webarchive|url=https://web.archive.org/web/20130911021653/https://sites.google.com/site/psych54000/a |date=2013-09-11 }} Nathaniel Deyoung, Purdue University. Retrieved 9 Sept 2013</ref>
In 1892, the Superintendents' Association expanded its membership to include other mental health workers, and renamed to the [[American Psychiatric Association|American Medico-Psychological Association]] (AMPA).<ref>{{Cite book |title=The history and influence of the American Psychiatric Association |vauthors=Barton WE |date=1987 |publisher=American Psychiatric Press |others=American Psychiatric Association |isbn=0-88048-231-1 |location=Washington, D.C. |page=89 |oclc=13945621}}</ref>
In 1893, a French physician, [[Jacques Bertillon]], introduced the ''Bertillon Classification of Causes of Death'' at a congress of the [[International Statistical Institute]] (ISI) in Chicago.<ref>[https://archive.org/search.php?query=%28%28subject%3A%22Bertillon%2C%20Jacques%22%20OR%20subject%3A%22Jacques%20Bertillon%22%20OR%20creator%3A%22Bertillon%2C%20Jacques%22%20OR%20creator%3A%22Jacques%20Bertillon%22%20OR%20creator%3A%22Bertillon%2C%20J%2E%22%20OR%20title%3A%22Jacques%20Bertillon%22%20OR%20description%3A%22Bertillon%2C%20Jacques%22%20OR%20description%3A%22Jacques%20Bertillon%22%29%20OR%20%28%221851-1922%22%20AND%20Bertillon%29%29%20AND%20%28-mediatype:software%29 Works of Jacques Bertillon], Internet Archive.</ref><ref name="History">{{cite web |title=''History of the development of the ICD''. |url=https://www.who.int/entity/classifications/icd/en/HistoryOfICD.pdf |access-date=11 December 2017 |website=Who.int}}</ref> (The ISI had commissioned him to create it in 1891).<ref name="History" /> A number of countries adopted the ISI's system. In 1898, the [[American Public Health Association]] (APHA) recommended that United States registrars also adopt the system.<ref name="History" />
In 1900, an ISI conference in Paris reformed the Bertillion Classification, and created the ''[[International Classification of Diseases|International List of Causes of Death]]'' (ILCD)''.<ref name="History" />'' Another conference would be held every ten years, and a new edition of the ILCD would be released. Five were ultimately issued. Non-fatal conditions were not included.
In 1903, New York's [[Bellevue Hospital]] published "The Bellevue Hospital nomenclature of diseases and conditions", which included a section on "Diseases of the Mind". Revisions were released in 1909 and 1911. It was produced with the assistance of the AMA and Bureau of the Census.<ref>{{Cite book |url=https://wellcomecollection.org/works/u4swa3m3/ |title=The Bellevue Hospital nomenclature of diseases and conditions |publisher=Bellvue and Allied Hospitals |year=1911 |edition=3rd |location=New York}}</ref>
===APA Statistical Manual (1917) and AMA Standard (1933)===
In 1917, together with the National Commission on Mental Hygiene (now [[Mental Health America]]), the American Medico-Psychological Association developed a new guide for mental hospitals called the ''Statistical Manual for the Use of Institutions for the Insane''. This guide included twenty-two diagnoses. It would be revised several times by the Association, and by the tenth edition in 1942, was titled ''Statistical Manual for the Use of Hospitals of Mental Diseases''.<ref>[https://archive.org/details/statisticalmanu00assogoog Statistical manual for the use of institutions for the insane (1918)] University of Michigan via Internet Archive</ref><ref>{{cite journal | vauthors = Clark LA, Cuthbert B, Lewis-Fernández R, Narrow WE, Reed GM | title = Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health's Research Domain Criteria (RDoC) | journal = Psychological Science in the Public Interest | volume = 18 | issue = 2 | pages = 72–145 | date = September 2017 | pmid = 29211974 | doi = 10.1177/1529100617727266 | s2cid = 206743519 | doi-access = free }}</ref>
In 1921, the AMPA became the present [[American Psychiatric Association]] (APA).<ref>{{Cite book |title=The history and influence of the American Psychiatric Association |vauthors=Barton WE |date=1987 |publisher=American Psychiatric Press |others=American Psychiatric Association |isbn=0-88048-231-1 |location=Washington, D.C. |pages=168 |oclc=13945621}}</ref>
The first edition of the DSM notes in its foreword: "In the late twenties, each large teaching center employed a system of its own origination, no one of which met more than the immediate needs of the local institution."<ref name=":8">{{cite web | url=https://archive.org/details/dsm-1 | title=DSM-1 Full PDF | year=1952 }}</ref>
In 1933, the AMA's general medical guide the ''Standard Classified Nomenclature of Disease'', (referred to as the ''Standard),'' was released.<ref>{{Cite journal |date=December 1933 |title=A Standard Classified Nomenclature of Disease |url=https://journals.lww.com/jonmd/Citation/1933/12000/A_Standard_Classified_Nomenclature_of_Disease.75.aspx |journal=The Journal of Nervous and Mental Disease |language=en-US |volume=78 |issue=6 |page=679 |doi=10.1097/00005053-193312000-00075 |issn=0022-3018|last1=Logie |first1=H. B. |doi-access=free }}</ref> Along with the [[New York Academy of Medicine]], the APA provided the psychiatric [[nomenclature]] subsection.<ref>{{cite journal | vauthors = Greenberg SA, Shuman DW, Meyer RG | title = Unmasking forensic diagnosis | journal = International Journal of Law and Psychiatry | volume = 27 | issue = 1 | pages = 1–15 | year = 2004 | pmid = 15019764 | doi = 10.1016/j.ijlp.2004.01.001 }}</ref> It became well adopted in the US within two years.<ref name=":8" /> A major revision of the Statistical Manual was made in 1934, to bring it in line with the new Standard.<ref name=":8" /> A number of revisions of the Standard were produced, with the last in 1961.<ref>{{Cite book |title=Standard nomenclature of diseases and operations |publisher=McGraw Hill |year=1961 |editor-last=Thompson |editor-first=ET |edition=5th |location=New York |editor-last2=Hayden |editor-first2=AC}}</ref>
===Medical 203 (1945)===
[[World War II]] saw the large-scale involvement of U.S. psychiatrists in the selection, processing, assessment, and treatment of soldiers.<ref>{{Cite book |last= |first= |url=https://books.google.com/books?id=BHEwAAAAIAAJ |title=The Medical Department of the United States Army in World War II. |collaboration=United States Army Medical Service |date=1966 |publisher=Office of the Surgeon General, Department of the Army |page=756 |language=en}}</ref> This moved the focus away from mental institutions and traditional clinical perspectives. The U.S. armed forces initially used the Standard, but found it lacked appropriate categories for many common conditions that troubled troops. The [[US Navy|United States Navy]] made some minor revisions but "the Army established a much more sweeping revision, abandoning the basic outline of the Standard and attempting to express present-day concepts of mental disturbance."<ref name=":8" />
Under the direction of [[James Forrestal]],<ref name="NavyPsyc2">{{cite web |vauthors=Sobocinski A |title=A Brief History of U.S. Navy Psychiatric Diagnoses, Part II |url=https://navymedicine.navylive.dodlive.mil/archives/7192 |website=Navy Medicine Live |publisher=U.S. Navy Bureau of Medicine and Surgery |access-date=28 April 2020 |archive-date=20 April 2020 |archive-url=https://web.archive.org/web/20200420113904/https://navymedicine.navylive.dodlive.mil/archives/7192 }}</ref> a committee headed by psychiatrist [[Brigadier General (United States)|Brigadier General]] [[William C. Menninger]], with the assistance of the Mental Hospital Service,<ref>{{Cite journal |pmc = 2015553|year = 1953| vauthors = Sandison RA, Spencer AM |title = Mental Hospital Service|journal = British Medical Journal|volume = 1|issue = 4809|pages = 560|doi = 10.1136/bmj.1.4809.560}}</ref> developed a new classification scheme in 1944 and 1945.
Issued in War Department Technical Bulletin, Medical, 203 (TB MED 203); ''Nomenclature and Method of Recording Diagnoses'' was released shortly after the war in October 1945 under the auspices of the [[Office of the Surgeon General]].<ref name="Houts2000">{{cite journal | vauthors = Houts AC | title = Fifty years of psychiatric nomenclature: reflections on the 1943 War Department Technical Bulletin, Medical 203 | journal = Journal of Clinical Psychology | volume = 56 | issue = 7 | pages = 935–967 | date = July 2000 | pmid = 10902952 | doi = 10.1002/1097-4679(200007)56:7<935::AID-JCLP11>3.0.CO;2-8 | url = http://www3.interscience.wiley.com/journal/72506618/abstract | archive-url = https://archive.today/20130105054908/http://www3.interscience.wiley.com/journal/72506618/abstract | archive-date = 2013-01-05 }}</ref> It was reprinted in the [[Journal of Clinical Psychology]] for civilian use in July 1946 with the new title ''Nomenclature of Psychiatric Disorders and Reactions''.<ref>{{Cite journal |date=July 1946 |title=Nomenclature of psychiatric disorders and reactions |url=https://onlinelibrary.wiley.com/doi/10.1002/1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O |journal=[[Journal of Clinical Psychology]] |volume=2 |issue=3 |pages=289–296|doi=10.1002/1097-4679(194607)2:3<289::AID-JCLP2270020316>3.0.CO;2-O |pmid=20992064 }}</ref> This system came to be known as "Medical 203".
This nomenclature eventually was adopted by all the armed forces, and "assorted modifications of the Armed Forces nomenclature [were] introduced into many clinics and hospitals by psychiatrists returning from military duty."<ref name=":8" /> The [[United States Department of Veterans Affairs|Veterans Administration]] also adopted a slightly modified version of the standard in 1947.<ref name="NavyPsyc2" />
The further developed ''Joint Armed Forces Nomenclature and Method of Recording Psychiatric Conditions'' was released in 1949.<ref>{{Cite book |last=U.S. Army. U.S. Navy. U.S. Air Force |url=http://archive.org/details/NOMENCLATUREANDMETHODOFRECORDINGPSYCHIATRICCONDITIONS |title=Joint Armed Forces Nomenclature and Method of Recording Psychiatric Conditions |date=1949}}</ref>
===ICD-6 (1948)===
In 1948, the newly formed [[World Health Organization]] took over the maintenance of the ILCD. They greatly expanded it, included non-fatal conditions for the first time, and renamed it the ''[[International Statistical Classification of Diseases]]'' (ICD). The foreword to the DSM-I states the ICD-6 "categorized mental disorders in rubrics similar to those of the Armed Forces nomenclature."<ref name=":8" />
== Early versions (20th century) ==
===DSM-I (1952)===
The APA Committee on Nomenclature and Statistics was empowered to develop a version of Medical 203 specifically for use in the United States, to standardize the diverse and confused usage of different documents. In 1950, the APA committee undertook a review and consultation. It circulated an adaptation of Medical 203, the ''Standard''{{'}}s nomenclature, and the VA system's modifications of the ''Standard'' to approximately 10% of APA members. 46% of members replied, with 93% approving the changes. After some further revisions, the ''Diagnostic and Statistical Manual of Mental Disorders'' was approved in 1951 and published in 1952. The structure and conceptual framework were the same as in Medical 203, and many passages of text were identical.<ref name="Houts2000"/> The manual was 130 pages long and listed 106 mental disorders.<ref>{{cite journal | vauthors = Grob GN | title = Origins of DSM-I: a study in appearance and reality | journal = The American Journal of Psychiatry | volume = 148 | issue = 4 | pages = 421–431 | date = April 1991 | pmid = 2006685 | doi = 10.1176/ajp.148.4.421 }}</ref> These included several categories of "personality disturbance", generally distinguished from "neurosis" (nervousness, [[egodystonic]]).<ref name="Oldham">{{cite journal| vauthors = Oldham JM |title=Personality Disorders|journal=FOCUS|year=2005|volume=3|pages=372–382|url=http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21|archive-url=https://archive.today/20120720080755/http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21|archive-date=2012-07-20}}</ref>
The foreword to this edition describes itself as being a continuation of the ''Statistical Manual for the Use of Hospitals of Mental Diseases.<ref name=":8" />'' Each item was given an ICD-6 equivalent code, where applicable.
[[File:Statistical card for use in hospitals for mental illness.jpg|thumb]]
The DSM-I centers around three classes of symptoms: psychotic, neurotic, and behavioral.<ref name=":9">{{Cite web |date=1952 |title=Diagnostic and Statistical Manual |url=http://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf |access-date=April 25, 2023 |website=American Psychiatric Association |publisher=The Committee on Nomenclature and Statistics}}</ref> Within each class of mental disorder, classifying information is provided to differentiate conditions with similar symptoms. Under each broad class of disorder (e.g. "Psychoneurotic Disorders" or "Personality Disorders"), all possible diagnoses are listed, generally from least to most severe.<ref name=":9" /> The 1952 DSM version also includes sections detailing how to record patients' disorders along with their demographic details.<ref name=":9" /> The form includes information like a patient's area of residence, admission status, discharge date/condition, and severity of disorder.<ref name=":9" /> See Figure 1. for the form that psychiatrists were asked to utilize for recording preliminary diagnostic information.<ref name=":9" />
Furthermore, the APA listed homosexuality in the DSM as a [[Antisocial personality disorder|sociopathic]] personality disturbance. ''[[Homosexuality: A Psychoanalytic Study of Male Homosexuals]]'', a large-scale 1962 study of homosexuality by [[Irving Bieber]] and other authors, was used to justify inclusion of the disorder as a supposed pathological hidden fear of the opposite sex caused by traumatic parent–child relationships. This view was influential in the medical profession.<ref name=":0">{{Cite book| vauthors = Edsall NC |title=Toward Stonewall: Homosexuality and Society in the Modern Western World|publisher=University of Virginia Press|year=2003}}</ref> In 1956, however, the psychologist [[Evelyn Hooker]] performed a study comparing the happiness and well-adjusted nature of self-identified homosexual men with heterosexual men and found no difference.<ref name=":0" /> Her study stunned the medical community and made her a heroine to many gay men and lesbians,<ref>{{Cite book | vauthors = Marcus E |title=Making Gay History |publisher=Harper Collins |year=2009 |location=Print |pages=58–59}}</ref> but homosexuality remained in the DSM until May 1974.<ref>{{cite book|chapter-url=https://books.google.com/books?id=drBejRLWkHkC&pg=PA76 |chapter=The Transformation of Mental Disorders in the 1980s: The DSM-III, Managed Care, and "Cosmetic Psychopharmacology" |page=76 |title=Medicating Children: ADHD and Pediatric Mental Health | vauthors = Mayes R, Bagwell C, Erkulwater JL |publisher=Harvard University Press |date= 2009 |access-date=2013-12-03 |isbn=978-0-674-03163-0 }}</ref>
===DSM-II (1968)===
In the 1960s, there were many challenges to the concept of [[mental illness]] itself. These challenges came from psychiatrists like [[Thomas Szasz]], who argued mental illness was a myth used to disguise moral conflicts; from sociologists such as [[Erving Goffman]], who said mental illness was another example of how society labels and controls non-conformists; from [[behavioural psychologist]]s who challenged psychiatry's fundamental reliance on unobservable phenomena; and from gay rights activists who criticised the APA's listing of homosexuality as a mental disorder.
The APA was closely involved in the next significant revision of the mental disorder section of the ICD (version 8 in 1968). It decided to go ahead with a revision of the DSM, which was published in 1968. DSM-II was similar to DSM-I, listed 182 disorders, and was 134 pages long. The term "reaction" was dropped, but the term "[[neurosis]]" was retained. Both the DSM-I and the DSM-II reflected the predominant [[psychodynamic]] psychiatry,<ref name = "Revolution">{{cite journal | vauthors = Mayes R, Horwitz AV | title = DSM-III and the revolution in the classification of mental illness | journal = Journal of the History of the Behavioral Sciences | volume = 41 | issue = 3 | pages = 249–267 | year = 2005 | pmid = 15981242 | doi = 10.1002/jhbs.20103 }}</ref> although both manuals also included biological perspectives and concepts from [[Emil Kraepelin|Kraepelin]]'s system of classification. Symptoms were not specified in detail for specific disorders. Many were seen as reflections of broad underlying conflicts or maladaptive reactions to life problems that were rooted in a distinction between neurosis and [[psychosis]] (roughly, anxiety/depression broadly in touch with reality, as opposed to [[hallucinations]] or [[delusions]] disconnected from reality). Sociological and biological knowledge was incorporated, under a model that did not emphasize a clear boundary between normality and abnormality.<ref name="Transformation">{{cite journal | vauthors = Wilson M | title = DSM-III and the transformation of American psychiatry: a history | journal = The American Journal of Psychiatry | volume = 150 | issue = 3 | pages = 399–410 | date = March 1993 | pmid = 8434655 | doi = 10.1176/ajp.150.3.399 }}</ref> The idea that personality disorders did not involve emotional distress was discarded.<ref name=Oldham/>
A study published in ''Science'' in 1973, the [[Rosenhan experiment]], received much publicity and was viewed as an attack on the efficacy of psychiatric diagnosis.<ref name="Stuart A, Kirk & Herb Kutchins 1994">{{cite web |url=http://www.academyanalyticarts.org/kirk&kutchins.htm |title=The Myth of the Reliability of DSM | vauthors = Kirk SA, Kutchins H |year=1994 |work=Journal of Mind and Behavior, 15 (1&2) |archive-url=https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk%26kutchins.htm |archive-date=2008-03-07 }}</ref>
An influential 1974 paper by [[Robert Spitzer (psychiatrist)|Robert Spitzer]] and [[Joseph L. Fleiss]] demonstrated that the second edition of the DSM (DSM-II) was an unreliable diagnostic tool.<ref name=SpitzerFleiss1974>{{cite journal | vauthors = Spitzer RL, Fleiss JL | title = A re-analysis of the reliability of psychiatric diagnosis | journal = The British Journal of Psychiatry | volume = 125 | pages = 341–347 | date = October 1974 | issue = 587 | pmid = 4425771 | doi = 10.1192/bjp.125.4.341 | s2cid = 37782257 }}</ref> Spitzer and Fleiss found that different practitioners using the DSM-II rarely agreed when diagnosing patients with similar problems. In reviewing previous studies of eighteen major diagnostic categories, Spitzer and Fleiss concluded that "there are no diagnostic categories for which reliability is uniformly high. Reliability appears to be only satisfactory for three categories: mental deficiency, organic brain syndrome (but not its subtypes), and alcoholism. The level of reliability is no better than fair for psychosis and [[schizophrenia]] and is poor for the remaining categories".<ref name="Kirk & Kutchins">{{cite journal | vauthors = Kirk SA, Kutchins H |year=1994 |title=The Myth of the Reliability of DSM |journal=Journal of Mind and Behavior |volume=15 |issue=1&2 |pages=71–86 |url= http://www.academyanalyticarts.org/kirk&kutchins.htm |access-date=2008-03-04 |archive-url=https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk%26kutchins.htm |archive-date=2008-03-07 }}</ref>
====Seventh printing of the DSM-II (1974)====
As described by Ronald Bayer, a psychiatrist and gay rights activist, specific protests by [[gay rights]] activists against the APA began in 1970, when the organization held its convention in [[San Francisco]]. The activists disrupted the conference by interrupting speakers and shouting down and ridiculing psychiatrists who viewed homosexuality as a mental disorder. In 1971, gay rights activist [[Frank Kameny]] worked with the [[Gay Liberation Front]] collective to demonstrate at the APA's convention. At the 1971 conference, Kameny grabbed the microphone and yelled: "Psychiatry is the enemy incarnate. Psychiatry has waged a relentless war of extermination against us. You may take this as a declaration of war against you."<ref>Bayer, Ronald (1981). [https://archive.org/details/homosexualityame00bayerich ''Homosexuality and American Psychiatry: The Politics of Diagnosis''] Princeton University Press p. 105.</ref>
This gay activism occurred in the context of a broader [[anti-psychiatry]] movement that had come to the fore in the 1960s and was challenging the legitimacy of psychiatric diagnosis. Anti-psychiatry activists protested at the same APA conventions, with some shared slogans and intellectual foundations as gay activists.<ref>{{cite journal | vauthors = McCommon B | title = Antipsychiatry and the gay rights movement | journal = Psychiatric Services | volume = 57 | issue = 12 | pages = 1809; author reply 1809–1809; author reply 1810 | date = December 2006 | pmid = 17158503 | doi = 10.1176/appi.ps.57.12.1809 | s2cid = 37419476 | url = http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809 | archive-url = https://web.archive.org/web/20070810054520/http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809 | archive-date = 2007-08-10 }}</ref><ref>{{cite journal | vauthors = Rissmiller DJ, Rissmiller J | year = 2006 | title = Letter in reply | url = http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a | journal = Psychiatr Serv | volume = 57 | issue = 12| pages = 1809–1810 | doi = 10.1176/appi.ps.57.12.1809-a | archive-url = https://web.archive.org/web/20070630022511/http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a | archive-date = 2007-06-30 }}</ref>
Taking into account data from researchers such as [[Alfred Kinsey]] and [[Evelyn Hooker]], the seventh printing of the DSM-II, in 1974, no longer listed homosexuality as a category of disorder.{{efn|Determining the correct DSM-II printing where the change occurred can be confusing because the American Psychiatric Association publication that announced the change is titled, in part, "Proposed change in DSM-II, 6th printing, page 44". However, a notice in that publication indicates that "the change appears on page 44 of this, the seventh printing."}} After a vote by the APA trustees in 1973, and confirmed by the wider APA membership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance".<ref>{{cite journal | vauthors = Spitzer RL | title = The diagnostic status of homosexuality in DSM-III: a reformulation of the issues | journal = The American Journal of Psychiatry | volume = 138 | issue = 2 | pages = 210–215 | date = February 1981 | pmid = 7457641 | doi = 10.1176/ajp.138.2.210 }}</ref><ref>[https://pages.uoregon.edu/eherman/teaching/texts/DSM-II_Homosexuality_Revision.pdf Homosexuality and sexuality orientation disturbance: Proposed change in DSM-II, 6th printing, page 44. Position Statement (Retired)]. APA Document Reference No. 730008. Arlington, VA: American Psychiatric Association, 1973. ("Since the last printing of this Manual, the trustees of the American Psychiatric Association, in December 1973, voted to eliminate Homosexuality per se as a mental disorder and to substitute therefor a new category titled Sexual Orientation Disturbance. The change appears on page 44 of this, the seventh printing.").</ref>
===DSM-III (1980)===
The emergence of DSM III represented a "quantum leap" in terms of the scale and reach of the manual.<ref name="Coolidge and Segal 1998">{{cite journal |last1=Coolidge |first1=Frederick L. |last2=Segal |first2=Daniel L. |title=Evolution of personality disorder diagnosis in the Diagnostic and statistical manual of mental disorders |url=https://www.sciencedirect.com/science/article/abs/pii/S0272735898000026 |journal=Clinical Psychology Review |date=August 1998 |volume=18 |issue=5 |pages=585–599 |doi=10.1016/s0272-7358(98)00002-6 |pmid=9740979 |access-date=27 September 2023}}</ref> In 1974, the decision to revise the DSM was made, and psychiatrist [[Robert Spitzer (psychiatrist)|Robert Spitzer]] was selected as chair of the task force. The initial impetus was to make the DSM nomenclature consistent with that of the [[International Classification of Diseases]] (ICD). The revision took on a far wider mandate under the influence and control of Spitzer and his chosen committee members.<ref>{{cite magazine | vauthors = Spiegel A |url= http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact |title=The Dictionary of Disorder: How one man revolutionized psychiatry |date=3 January 2005 |magazine=The New Yorker |archive-url=https://web.archive.org/web/20061212180933/http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact |archive-date=12 December 2006 }}</ref> One added goal was to improve the uniformity and validity of psychiatric diagnosis in the wake of a number of critiques, including the famous [[Rosenhan experiment]]. There was also felt a need to standardize diagnostic practices within the United States and with other countries, after research showed that psychiatric diagnoses differed between Europe and the United States.<ref name="PMID5774702">{{cite journal | vauthors = Cooper JE, Kendell RE, Gurland BJ, Sartorius N, Farkas T | title = Cross-national study of diagnosis of the mental disorders: some results from the first comparative investigation | journal = The American Journal of Psychiatry | volume = 10 Suppl | issue = 10 Suppl | pages = 21–29 | date = April 1969 | pmid = 5774702 | doi = 10.1176/ajp.125.10s.21 | url = http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30 | archive-url = https://web.archive.org/web/20100824224731/http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30 | archive-date = 2010-08-24 }}</ref> The establishment of consistent criteria was an attempt to facilitate the pharmaceutical regulatory process.
The criteria adopted for many of the mental disorders were influenced by the [[Research Diagnostic Criteria]] (RDC) and [[Feighner Criteria]], which had just been developed by a group of research-orientated psychiatrists based primarily at [[Washington University School of Medicine]] and the [[New York State Psychiatric Institute]]. However, the influence of clinical psychiatrists, themselves often working with psychoanalytic ideas were still strong.<ref>{{cite book |last1=Decker |first1=Hannah S. |title=The making of DSM-III®: a diagnostic manual's conquest of American psychiatry |date=2013 |publisher=Oxford University Press |location=Oxford New York Auckland |isbn=9780195382235}}</ref> Other criteria, and potential new categories of disorder, were established by debate, argument and consensus during meetings of the committee chaired by Spitzer. A key aim was to base categorization on colloquial English (which would be easier to use by federal administrative offices), rather than by assumption of cause, although its categorical approach still assumed each particular pattern of symptoms in a category reflected a particular underlying pathology (an approach described as "[[Emil Kraepelin|neo-Kraepelinian]]"). The [[psychodynamic]] view was marginalised, although still influential, in favor of a [[regulatory]] or [[legislative]] model that emphasised observable symptoms.<ref name="Decker (2013)">{{cite book |last1=Decker |first1=Hannah S. |title=The making of DSM-III®: a diagnostic manual's conquest of American psychiatry |date=2013 |publisher=Oxford University Press |location=Oxford New York Auckland |isbn=9780195382235}}</ref> A new "multiaxial" system attempted to yield a picture more amenable to a statistical population census, rather than a simple [[medical diagnosis|diagnosis]]. Spitzer argued "mental disorders are a subset of medical disorders", but the task force decided on this statement for the DSM: "Each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome."<ref name="Revolution"/> [[Personality disorders]] were placed on axis II along with "mental retardation".<ref name=Oldham/>
The first draft of DSM-III was ready within a year. It introduced many new categories of disorder, while deleting or changing others. A number of unpublished documents discussing and justifying the changes have recently come to light.<ref>{{cite book| vauthors = Lane C | title = Shyness: How Normal Behavior Became a Sickness| year = 2007| publisher = Yale University Press| isbn = 978-0-300-12446-0| page = [https://archive.org/details/shynesshownormal00lane/page/263 263]| url-access = registration| url = https://archive.org/details/shynesshownormal00lane/page/263}}</ref> Field trials sponsored by the U.S. [[National Institute of Mental Health]] (NIMH) were conducted between 1977 and 1979 to test the reliability of the new diagnoses. A controversy emerged regarding deletion of the concept of neurosis, a mainstream of [[psychoanalytic]] theory and therapy but seen as vague and unscientific by the DSM task force. Faced with enormous political opposition, DSM-III was in serious danger of not being approved by the APA Board of Trustees unless "neurosis" was included in some form; a political compromise reinserted the term in parentheses after the word "disorder" in some cases. Additionally, the diagnosis of [[Ego-dystonic sexual orientation|ego-dystonic homosexuality]] replaced the DSM-II category of "sexual orientation disturbance". The [[Gender dysphoria in children|gender identity disorder in children]] (GIDC) diagnosis was introduced in the DSM-III; prior to the DSM-III's publication in 1980, there was no diagnostic criteria for [[gender dysphoria]].<ref>{{cite book | publisher = American Psychiatric Association | date = 1980 | title = Diagnostic and statistical manual of mental disorders | edition = 3rd | location = Washington, DC }}</ref><ref name="Need">{{Cite journal|last1=Butler|first1=Catherine|last2=Hutchinson|first2=Anna|year=2020|title=Debate: The pressing need for research and services for gender desisters/Detransitioners|journal=Child and Adolescent Mental Health|volume=25|issue=1|pages=45–47|doi=10.1111/camh.12361|pmid=32285632|s2cid=210484832|url=https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf |archive-url=https://web.archive.org/web/20221128201913/https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf |archive-date=2022-11-28 |url-status=live }}</ref>
Finally published in 1980, DSM-III listed 265 diagnostic categories and was 494 pages long. It rapidly came into widespread international use and has been termed a revolution, or transformation, in psychiatry.<ref name="Revolution"/><ref name="Transformation"/>
When DSM-III was published, the developers made extensive claims about the reliability of the radically new diagnostic system they had devised, which relied on data from special field trials. However, according to a 1994 article by [[Stuart A. Kirk]]:
{{blockquote|Twenty years after the reliability problem became the central focus of DSM-III, there is still not a single multi-site study showing that DSM (any version) is routinely used with high reliably by regular mental health clinicians. Nor is there any credible evidence that any version of the manual has greatly increased its reliability beyond the previous version. There are important methodological problems that limit the generalizability of most reliability studies. Each reliability study is constrained by the training and supervision of the interviewers, their motivation and commitment to diagnostic accuracy, their prior skill, the homogeneity of the clinical setting in regard to patient mix and base rates, and the methodological rigor achieved by the investigator ...<ref name="Stuart A, Kirk & Herb Kutchins 1994"/>}}
===DSM-III-R (1987)===
In 1987, DSM-III-R was published as a revision of the DSM-III, under the direction of Spitzer. Categories were renamed and reorganized, with significant changes in criteria. Six categories were deleted while others were added. Controversial diagnoses, such as [[Premenstrual dysphoric disorder|Premenstrual Dysphoric Disorder]] and [[Self-defeating personality disorder|Masochistic Personality Disorder]], were considered and discarded. (Premenstrual Dysphoric Disorder was later reincorporated in the DSM-5, published in 2013).<ref>American Psychological Association. (2013). ''Highlights of Changes from DSM-IV-TR to DSM-5'' [Fact sheet]. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf</ref> "Ego-dystonic homosexuality" was also removed and was largely subsumed under "sexual disorder not otherwise specified", which could include "persistent and marked distress about one's sexual orientation."<ref name="Revolution"/><ref>{{cite web | vauthors = Spiegel A, Glass I |date=18 January 2002 |url=http://www.thisamericanlife.org/radio-archives/episode/204/81-words |title=81 Words |website=This American Life |location=Chicago |publisher=WBEZ Chicago Public Radio }}</ref> Altogether, the DSM-III-R contained 292 diagnoses and was 567 pages long. Further efforts were made for the diagnoses to be purely descriptive, although the introductory text stated for at least some disorders, "particularly the Personality Disorders, the criteria require much more inference on the part of the observer"[page xxiii].<ref name=Oldham/>
===DSM-IV (1994)===
In 1994, DSM-IV was published, listing 410 disorders in 886 pages. The task force was chaired by [[Allen Frances]] and was overseen by a steering committee of twenty-seven people, including four psychologists. The steering committee created thirteen work groups of five to sixteen members, each work group having about twenty advisers in addition. The work groups conducted a three-step process: first, each group conducted an extensive literature review of their diagnoses; then, they requested data from researchers, conducting analyses to determine which criteria required change, with instructions to be conservative; finally, they conducted multi-center field trials relating diagnoses to clinical practice.<ref>{{cite book |vauthors=Frances A, Mack AH, Ross R, First MB |date=2000 |orig-date=1995 |chapter-url=http://www.acnp.org/G4/GN401000082/CH081.html |chapter=The DSM-IV Classification and Psychopharmacology |title=Psychopharmacology: The Fourth Generation of Progress |publisher=American College of Neuropsychopharmacology |veditors=Bloom FE, Kupfer DJ |access-date=2007-02-28 |archive-date=2007-03-23 |archive-url=https://web.archive.org/web/20070323150804/http://www.acnp.org/G4/GN401000082/CH081.html }}</ref><ref>{{cite journal | vauthors = Shaffer D | title = A participant's observations: preparing DSM-IV | journal = Canadian Journal of Psychiatry | volume = 41 | issue = 6 | pages = 325–329 | date = August 1996 | pmid = 8862851 | doi = 10.1177/070674379604100602 | s2cid = 28547523 }}</ref> A major change from previous versions was the inclusion of a clinical-significance criterion to almost half of all the categories, which required symptoms causing "clinically significant distress or impairment in social, occupational, or other important areas of functioning". Some personality-disorder diagnoses were deleted or moved to the appendix.<ref name=Oldham/>
==== DSM-IV Definitions ====
{{See also|DSM-IV codes}}
The DSM-IV characterizes a mental disorder as "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significant increased risk of suffering death, pain, disability, or an important loss of freedom".<ref>{{cite web | vauthors = Maisel ER | date = 23 July 2013 | title = The New Definition of a Mental Disorder | work = Psychology Today |url = https://www.psychologytoday.com/us/blog/rethinking-mental-health/201307/the-new-definition-mental-disorder }}</ref> It also notes that "although this manual provides a classification of mental disorders it must be admitted that no definition adequately specifies precise boundaries for the concept of 'mental disorder."<ref name="pmid20624327">{{cite journal | vauthors = Stein DJ, Phillips KA, Bolton D, Fulford KW, Sadler JZ, Kendler KS | title = What is a mental/psychiatric disorder? From DSM-IV to DSM-V | journal = Psychological Medicine | volume = 40 | issue = 11 | pages = 1759–1765 | date = November 2010 | pmid = 20624327 | pmc = 3101504 | doi = 10.1017/S0033291709992261 }}</ref>
==== DSM-IV Categorization ====
The DSM-IV is a categorical classification system. The categories are prototypes, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<ref>{{cite journal | vauthors = Maser JD, Patterson T | title = Spectrum and nosology: implications for DSM-V | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = 855–885 | date = December 2002 | pmid = 12462864 | doi = 10.1016/s0193-953x(02)00022-9 }}</ref> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from [[tic disorder]]s and several of the [[paraphilia]]s due to their [[egosyntonic]] nature. Each category of disorder has a numeric code taken from the [[ICD coding system]], used for health service (including insurance) administrative purposes.
==== {{anchor|DSM-IV-TR multi-axial system}}DSM-IV multi-axial system ====
The DSM-IV was organized into a five-part axial system. Axis I provided information about clinical disorders, or any mental condition other than personality disorders and what was referred to in DSM editions prior to DSM-V as "mental retardation". Those were both covered on Axis II. Axis III covered medical conditions that could impact a person's disorder or treatment of a disorder and Axis IV covered psychosocial and environmental factors affecting the person. Axis V was the GAF, or global assessment of functioning, which was basically a numerical score between 0 and 100 that measured how much a person's psychological symptoms impacted their daily life.<ref>{{Cite book |url=https://www.ncbi.nlm.nih.gov/books/NBK519711/ |title=DSM-IV to DSM-5 Changes: Overview |publisher=Substance Abuse and Mental Health Services Administration |year=2016 |location=Internet |pages=DSM-5 Changes: Implications for Child Serious Emotional Disturbance}}</ref>
==== DSM-IV Sourcebooks ====
The DSM-IV does not specifically cite its sources, but there are four volumes of "sourcebooks" intended to be APA's documentation of the guideline development process and supporting evidence, including literature reviews, data analyses, and field trials.<ref>{{cite book|title=DSM-IV Sourcebook|date=1994|publisher=American Psychiatric Association|isbn=978-0-89042-065-2|volume=1|location=Washington, DC|url-access=registration|url=https://archive.org/details/dsmivsourcebook0000unse}}</ref><ref>{{cite book|title=DSM-IV Sourcebook|date=1996|publisher=American Psychiatric Association|isbn=978-0-89042-069-0|volume=2|location=Washington, DC|url-access=registration|url=https://archive.org/details/dsmivsourcebook0000unse}}</ref><ref>{{cite book|title=DSM-IV Sourcebook|date=1997|publisher=American Psychiatric Association|isbn=978-0-89042-073-7|volume=3|location=Washington, DC|url-access=registration|url=https://archive.org/details/dsmivsourcebook0000unse}}</ref><ref>{{cite journal|date=October 1999|title=DSM-IV Sourcebook, vol. 4 (Book Forum: Assessment and Diagnosis)|url=http://ajp.psychiatryonline.org/article.aspx?articleid=173760|journal=American Journal of Psychiatry|volume=156|issue=10|page=1655|doi=10.1176/ajp.156.10.1655| vauthors = Sadock BJ |access-date=2013-12-03|archive-url=https://web.archive.org/web/20131206233357/http://ajp.psychiatryonline.org/article.aspx?articleid=173760|archive-date=2013-12-06}}</ref> The sourcebooks have been said to provide important insights into the character and quality of the decisions that led to the production of DSM-IV, and the scientific credibility of contemporary psychiatric classification.<ref name="Poland01vol1">{{cite book | vauthors = Poland JS | date = 2001 | url = http://mentalhelp.net/books/books.php?type=de&id=557 | title = Review of Volume 1 of DSM-IV sourcebook | archive-url =https://web.archive.org/web/20050501182254/http://mentalhelp.net/books/books.php?type=de&id=557| archive-date = May 1, 2005}}</ref><ref name="Poland01vol2">{{cite book | vauthors = Poland JS | date = 2001 | url = http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74 | title = Review of vol 2 of DSM-IV sourcebook | archive-url = https://web.archive.org/web/20070927005022/http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74| archive-date= September 27, 2007}}</ref>
===DSM-IV-TR (2000)===
A text revision of DSM-IV, titled DSM-IV-TR, was published in 2000. The diagnostic categories were unchanged as were the diagnostic criteria for all but nine diagnoses.<ref>{{cite web | title = DSM-IV replaced by DSM-IV-TR: changes in diagnostic criteria | work = Behavenet |url=https://behavenet.com/dsm-iv-replaced-dsm-iv-tr-changes-diagnostic-criteria}}</ref> The majority of the text was unchanged; however, the text of two disorders, pervasive developmental disorder not otherwise specified and Asperger's disorder, had significant and/or multiple changes made. The definition of pervasive developmental disorder not otherwise specified was changed back to what it was in DSM-III-R and the text for Asperger's disorder was practically entirely rewritten. Most other changes were to the associated features sections of diagnoses that contained additional information such as lab findings, demographic information, prevalence, and course. Also, some diagnostic codes were changed to maintain consistency with ICD-9-CM.<ref name="pmid11875221">{{cite journal | vauthors = First MB, Pincus HA | title = The DSM-IV Text Revision: rationale and potential impact on clinical practice | journal = Psychiatric Services | volume = 53 | issue = 3 | pages = 288–292 | date = March 2002 | pmid = 11875221 | doi = 10.1176/appi.ps.53.3.288 }}</ref>
==DSM-5 (2013)==
{{Main|DSM-5}}
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5, was approved by the Board of Trustees of the APA on December 1, 2012.<ref>{{cite news | vauthors = Cassels C |date=2 December 2012 |url=http://www.medscape.com/viewarticle/775496 |title=DSM-5 Gets APA's Official Stamp of Approval |publisher=WebMD, LLC |website=Medscape |access-date=2012-12-05}}</ref> Published on May 18, 2013,<ref>{{cite web|title=Explainer: what is the DSM?|url=http://theconversation.com/explainer-what-is-the-dsm-14127|work=The Conversation Australia|publisher=The Conversation Media Group|access-date=2013-05-21| vauthors = Kinderman P |date=20 May 2013}}</ref> the DSM-5 contains extensively revised diagnoses and, in some cases, broadens diagnostic definitions while narrowing definitions in other cases.<ref>{{cite news|title=Books blast new version of psychiatry's bible, the DSM|url=https://www.usatoday.com/story/news/nation/2013/05/12/dsm-psychiatry-mental-disorders/2150819/|access-date=2013-05-21|newspaper=USA Today|date=12 May 2013| vauthors = Jayson S }}</ref> The DSM-5 is the first major edition of the manual in 20 years.<ref>{{cite news|title=DSM-5 Changes: What Parents Need To Know About The First Major Revision In Nearly 20 Years|url=http://www.huffingtonpost.com/2013/05/20/dsm5-changes-what-parents-need-to-know_n_3294413.html|access-date=2013-05-21|newspaper=The Huffington Post|date=20 May 2013| vauthors = Pearson C }}</ref> DSM-5, and the abbreviations for all previous editions, are [[Trademark#Registration|registered trademarks]] owned by the American Psychiatric Association.<ref name="concept&evolution" /><ref name="titleTrademark''' Electronic Search System (TESS)">{{cite web |title=Trademark Electronic Search System (TESS) |url=http://tess2.uspto.gov/ |access-date=2010-02-03}}</ref>
A significant change in the fifth edition is the deletion of the subtypes of [[schizophrenia]]: [[paranoid schizophrenia|paranoid]], [[disorganized schizophrenia|disorganized]], [[catatonic schizophrenia|catatonic]], [[undifferentiated schizophrenia|undifferentiated]], and [[residual schizophrenia|residual]].<ref>{{cite web|title=Highlights of Changes from DSM-IV-TR to DSM-5 |website=American Psychiatric Association |date=17 May 2013 |url=http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf |access-date=2015-01-04 |archive-url=https://web.archive.org/web/20150226050453/http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf |archive-date=2015-02-26 }}</ref> The deletion of the subsets of [[Autism spectrum|autistic spectrum disorder]]{{snd}}namely, [[Asperger's syndrome]], [[classic autism]], [[Rett syndrome]], [[childhood disintegrative disorder]] and [[pervasive developmental disorder not otherwise specified]]{{snd}}was also implemented, with specifiers regarding intensity: mild, moderate, and severe.
Severity is based on social communication impairments and restricted, repetitive patterns of behavior, with three levels:
# requiring support
# requiring substantial support
# requiring very substantial support
During the revision process, the APA website periodically listed several sections of the DSM-5 for review and discussion.<ref>{{Cite web|url=https://www.psychiatry.org/psychiatrists/practice/dsm|title=DSM-5|website=psychiatry.org|access-date=2019-08-29}}</ref>
===Future revisions and updates===
Beginning with the fifth edition, the APA communicated that they intend to add subsequent revisions more often, to keep up with research in the field.<ref>{{Cite web|url=https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions|title=DSM-5 FAQ|website=psychiatry.org|access-date=2019-08-29}}</ref> It is notable that DSM-5 uses [[Arabic numerals|Arabic]] rather than [[Roman numerals]]. Beginning with DSM-5, the APA will use decimals to identify incremental updates (e.g., DSM-5.1, DSM-5.2){{efn|However, this planned change was not adopted for the initial revision of the DSM-5, which is named DSM-5-TR, in accordance with past convention.}} and whole numbers for new editions (e.g., DSM-5, DSM-6),<ref>{{cite press release | vauthors = Harold E, Valora J |title=APA Modifies ''DSM'' Naming Convention to Reflect Publication Changes |location=Arlington, VA |publisher=American Psychiatric Association |date=9 March 2010 |url=http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx |format=PDF |archive-url=https://web.archive.org/web/20100613144808/http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx |archive-date=13 June 2010 |quote=Beginning with the upcoming fifth edition, new versions of the ''Diagnostic and Statistical Manual of Mental Disorders (DSM)'' will be identified with Arabic rather than Roman numerals, marking a change in how future updates will be created, ... Incremental updates will be identified with decimals, i.e. ''DSM-5.1'', ''DSM-5.2'', etc., until a new edition is required.}}</ref> similar to the scheme used for [[software versioning]].
The National Board of Medical Examiners (NBME), which is responsible for creating and publishing board exams for medical students around the United States, conforms to the use of DSM-5 criteria.<ref>{{Citation | title=Update: Exams to Transition to DSM-5 | journal=Psychiatric News| year=2014| volume=49| issue=22| page=1| doi=10.1176/appi.pn.2014.10a19| url=https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2014.10a19}}</ref>
=== DSM-5-TR (2022) ===
A revision of DSM-5, titled DSM-5-TR, was published in March 2022, updating diagnostic criteria and [[ICD-10-CM]] codes.<ref name=":3">{{Cite web |title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR™) |url=https://www.appi.org/products/dsm |website=American Psychiatric Association |access-date=April 18, 2022}}</ref> The diagnostic criteria for [[avoidant/restrictive food intake disorder]] was changed,<ref name=":5">{{Cite journal |last1=Appelbaum |first1=Paul S. |last2=Leibenluft |first2=Ellen |author-link2=Ellen Leibenluft |last3=Kendler |first3=Kenneth S. |date=2021-11-01 |title=Iterative Revision of the ''DSM'': An Interim Report From the ''DSM-5'' Steering Committee |journal=Psychiatric Services |volume=72 |issue=11 |pages=1348–1349 |doi=10.1176/appi.ps.202100013 |issn=1075-2730 |pmid=33882702 |s2cid=233349377}}</ref> along with adding entries for [[prolonged grief disorder]], [[Unspecified Mood Disorder|unspecified mood disorder]] and [[Stimulant-Induced Mild Neurocognitive Disorder|stimulant-induced mild neurocognitive disorder]].<ref name=":6">{{Cite journal |last1=First |first1=Michael B. |last2=Yousif |first2=Lamyaa H. |last3=Clarke |first3=Diana E. |last4=Wang |first4=Philip S. |last5=Gogtay |first5=Nitin |last6=Appelbaum |first6=Paul S. |date=2022-05-07 |title=DSM-5-TR: overview of what's new and what's changed |journal=World Psychiatry |volume=21 |issue=2 |pages=218–219 |doi=10.1002/wps.20989 |pmid=35524596 |pmc=9077590 |issn=1723-8617}}</ref><ref>{{Cite news |date=2022-09-08 |title=Prolonged grief disorder recognized as official diagnosis. Here's what to know about chronic mourning. |language=en-US |newspaper=[[The Washington Post]] |url=https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/ |access-date=2023-05-23 |issn=0190-8286}}</ref> Prolonged grief disorder, which had been present in the ICD-11, had criteria agreed upon by consensus in a one day in-person workshop sponsored by the APA.<ref name=":5" /> A 2022 study found that higher rates of diagnosis of prolonged grief disorder in the ICD-11 could be explained by the DSM-5-TR criteria requiring symptoms persist for 12 months, and the ICD-11 requiring only 6 months.<ref>{{Cite journal |date=2022 |title=Supplemental Material for Same Name, Same Content? Evaluation of DSM-5-TR and ICD-11 Prolonged Grief Criteria |journal=Journal of Consulting and Clinical Psychology |doi=10.1037/ccp0000720.supp |s2cid=248338204 |issn=0022-006X}}</ref>
Three review groups for sex and gender, culture and suicide, along with an "ethnoracial equity and inclusion work group" were involved in the creation of the DSM-5-TR which led to additional sections for each mental disorder discussing sex and gender, racial and cultural variations, and adding diagnostic codes for specifying levels of suicidality and nonsuicidal self-injury for mental disorders.<ref name=":6" /><ref name=":5" />
Other changed mental disorders included:<ref name=":4">{{Cite web |title=Updates to DSM-5 Criteria & Text |url=https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-criteria-text |access-date=April 18, 2022 |website=American Psychiatric Association}}</ref>
* [[Autism spectrum|Autism spectrum disorder]]
* [[Bipolar I disorder]], [[Bipolar II disorder]], and related [[bipolar disorder]]s
* [[Obsessive–compulsive personality disorder]] in the [[alternative DSM-5 model for personality disorders]]
* [[Major depressive episode|Depressive episodes]] with short-duration [[hypomania]]
* [[Intellectual disability|Intellectual developmental disorder]]
* [[Delusional disorder]]
* [[Disruptive mood dysregulation disorder]]
* [[Brief psychotic disorder]]
==DSM Library==
The APA have supplemented the DSM with supporting works, collectively forming the "DSM Library."<ref name=":7">{{Cite web |title=Psychiatry Online |url=https://dsm.psychiatryonline.org/ |access-date=2022-11-07 |website=DSM Library |language=en}}</ref> As of 2022, the other books in the library are "DSM-5 Handbook of Differential Diagnosis", "DSM-5 Clinical Cases", "DSM-5 Handbook on the Cultural Formulation Interview" and "Guía De Consulta De Los Criterios Diagnósticos Del DSM-5".<ref name=":7" />
==Criticisms==
Many criticisms have been leveled against the DSM and its usefulness as a diagnostic manual.
===Reliability and validity===
The revisions of the DSM from the 3rd Edition forward have been mainly concerned with [[Inter-rater reliability|diagnostic reliability]]{{snd}}the degree to which different diagnosticians agree on a diagnosis. Henrik Walter argued that psychiatry as a science can only advance if diagnosis is reliable. If clinicians and researchers frequently disagree about the diagnosis of a patient, then research into the causes and effective treatments of those disorders cannot advance. Hence, diagnostic reliability was a major concern of DSM-III. When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria. Neither the issue of reliability or validity was settled.<ref>{{cite web | vauthors = Ghaemi SN, Knoll IV JL, Pearlman T |date=14 October 2013 |title=Why DSM-III, IV, and 5 are Unscientific |website=Psychiatric Times: Couch in Crisis Blog |url=http://www.psychiatrictimes.com/blogs/couch-crisis/why-dsm-iii-iv-and-5-are-unscientific }}</ref><ref>{{cite journal | vauthors = Khoury B, Langer EJ, Pagnini F | title = The DSM: mindful science or mindless power? A critical review | journal = Frontiers in Psychology | volume = 5 | pages = 602 | date = 2014 | pmid = 24987385 | pmc = 4060802 | doi = 10.3389/fpsyg.2014.00602 | doi-access = free }}</ref>
In 2013, shortly before the publication of DSM-5, the director of the [[National Institute of Mental Health]] (NIMH), [[Thomas R. Insel]], declared that the agency would no longer fund research projects that relied exclusively on DSM diagnostic criteria, due to its lack of validity.<ref>{{cite web |vauthors=Insel T |date=29 April 2013 |title=Transforming Diagnosis |url=http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml |website=Director's Blog |publisher=National Institute of Mental Health |access-date=2013-09-02 |archive-date=2013-05-29 |archive-url=https://web.archive.org/web/20130529152509/http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml }}</ref> Insel questioned the validity of the DSM classification scheme because "diagnoses are based on a consensus about clusters of clinical symptoms" as opposed to "collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response."<ref>{{Cite web|url=https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml|title=NIMH » Transforming Diagnosis|website=nimh.nih.gov|language=en|access-date=2019-02-25|archive-date=2019-02-23|archive-url=https://web.archive.org/web/20190223235629/https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml}}</ref><ref>{{cite magazine| vauthors = Lane C |title=The NIMH Withdraws Support for DSM-5|url=http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5|magazine=Psychology Today}}</ref>
Field trials of DSM-5 brought the debate of reliability back into the limelight, as the diagnoses of some disorders showed poor reliability. For example, a diagnosis of [[major depressive disorder]], a common mental illness, had a poor reliability [[Cohen's kappa|kappa]] statistic of 0.28, indicating that clinicians frequently disagreed on diagnosing this disorder in the same patients. The most reliable diagnosis was major neurocognitive disorder, with a kappa of 0.78.<ref>{{cite journal | vauthors = Freedman R, Lewis DA, Michels R, Pine DS, Schultz SK, Tamminga CA, Gabbard GO, Gau SS, Javitt DC, Oquendo MA, Shrout PE, Vieta E, Yager J | display-authors = 6 | title = The initial field trials of DSM-5: new blooms and old thorns | journal = The American Journal of Psychiatry | volume = 170 | issue = 1 | pages = 1–5 | date = January 2013 | pmid = 23288382 | doi = 10.1176/appi.ajp.2012.12091189 | url = http://ajp.psychiatryonline.org/article.aspx?articleid=1555604 | archive-url = https://web.archive.org/web/20130115024502/http://ajp.psychiatryonline.org/article.aspx?articleID=1555604 | author-link8 = Susan Shur-Fen Gau | archive-date = 2013-01-15 }}</ref>
===Diagnosis based on superficial symptoms===
By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect these disorders based on statistical or clinical patterns. As such, it has been compared to a naturalist's field guide to birds, with similar advantages and disadvantages.<ref>{{cite journal | vauthors = McHugh PR | title = Striving for coherence: psychiatry's efforts over classification | journal = JAMA | volume = 293 | issue = 20 | pages = 2526–2528 | date = May 2005 | pmid = 15914753 | doi = 10.1001/jama.293.20.2526 }}</ref> The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. Proponents argue this absence of explanatory classification is necessary, but it presents a problem for researchers as it results in the grouping of individuals who may have little in common except superficial criteria.<ref name="concept&evolution" /><ref>Fadul. J. A. (2014) Diagnostic and Statistical Manual of Mental Disorders. In ''Encyclopedia of Theory & Practice in Psychopathology & Counseling.'' (p. 143). Raleigh, NC: Lulu Press.</ref> As [[DSM-III]] chief architect [[Robert Spitzer (psychiatrist)|Robert Spitzer]] and [[DSM-IV]] editor Michael First outlined in 2005, "little progress has been made toward understanding the [[pathophysiology|pathophysiological]] processes and cause of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."<ref>{{cite journal | vauthors = Davis JB | title = Classification of psychiatric disorders | journal = Canadian Medical Association Journal | volume = 122| issue = 7| date = April 1980 | page = 750 | pmid = 20313414 | pmc = 1801862| doi = }}</ref>
While there is generally a lack of consensus on underlying causation for most psychiatric disorders, some proponents of specific [[psychopathology|psychopathological]] paradigms have faulted the DSM for failing to incorporate evidence from other disciplines. For instance, [[evolutionary psychology]] distinguishes between genuine cognitive malfunctions and malfunctions due to psychological [[adaptations]] (that is learned behaviors may be adaptive in one context but maladaptive in another). However, this distinction is one that is challenged within general psychology.<ref>{{cite web | vauthors = Murphy D, Stich S |date=16 December 1998 |url=http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html |title=Darwin in the Madhouse: Evolutionary Psychology and the Classification of Mental Disorders |access-date=2013-12-03 |archive-url=https://web.archive.org/web/20131205122638/http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html |archive-date=5 December 2013 }}</ref><ref>{{cite journal | vauthors = Cosmides L, Tooby J | title = Toward an evolutionary taxonomy of treatable conditions | journal = Journal of Abnormal Psychology | volume = 108 | issue = 3 | pages = 453–464 | date = August 1999 | pmid = 10466269 | doi = 10.1037/0021-843x.108.3.453 }}</ref><ref>{{cite journal | vauthors = McNally RJ | title = On Wakefield's harmful dysfunction analysis of mental disorder | journal = Behaviour Research and Therapy | volume = 39 | issue = 3 | pages = 309–314 | date = March 2001 | pmid = 11227812 | doi = 10.1016/S0005-7967(00)00068-1 }}</ref>
There is also criticism of the strong [[Operationalization|operationalist]] viewpoint of the DSM. The DSM relies on [[operational definition]]s, which means that intuitive concepts like [[Depression (mood)|depression]] are defined by specific measurable criteria (observable behavior, specific timelines). Some have argued that instead of replacing metaphysical terms like "desire" or "purpose" the DSM chose to legitimize them by giving them operational definitions. However, this may have served only to provide a "reassurance fetish" for mainstream methodological practice, rather than representing a substantial and meaningful alteration of mainstream psychiatric practice.<ref>{{cite journal | vauthors = Hands DW |date=December 2004 |title=On Operationalisms and Economics |journal=Journal of Economic Issues |volume=38 |issue=4 |pages=953–968 |doi=10.1080/00213624.2004.11506751 |s2cid=141997867 }}</ref>
A central problem with the use of superficial symptoms is that psychiatry deals with the [[phenomenology (psychology)|phenomena]] of [[consciousness]], which adds much more complexity than the [[somatic symptom disorder|somatic]] [[symptom]]s and [[medical sign|signs]] used by most of medicine. A 2013 review published in the ''[[European Archives of Psychiatry and Clinical Neuroscience]]'' gives the example of the problem of superficial characterization of psychiatric signs and symptoms . If a patient says they "feel depressed, sad, or down" there are actually a wide variety of underlying experiences they could be referencing: "not only [[depression (mood)|depressed mood]] but also, for instance, [[irritability|irritation]], [[anger]], loss of meaning, varieties of [[fatigue (medical)|fatigue]], [[ambivalence]], [[rumination (psychology)|ruminations]] of different kinds, hyper-reflectivity, thought pressure, psychological [[anxiety]], varieties of [[depersonalization]], and even [[auditory hallucination|voices]] with negative content, and so forth." This criticism is especially pertinent to the [[structured interview]], as simple "yes or no" questions may not be specific enough to truly confirm or deny the [[diagnostic criteria|diagnostic criterion]] at issue. That is, whether a patient says yes or no will rely on their own understanding of the meaning of the various words in the question as well as their own interpretation of their experience. There is thus danger in being overconfident in the face value of the answers. The authors of the 2013 review give an example: A [[patient]] who was being administered the [[Structured Clinical Interview for DSM-IV|Structured Clinical Interview for the DSM-IV Axis I Disorders]] denied [[thought insertion]], but during a "conversational, [[phenomenology (psychology)|phenomenological]] interview", a [[semi-structured interview]] tailored to the patient, the same [[patient]] admitted to experiencing [[thought insertion]], along with a [[delusion|delusional elaboration]]. The authors suggested 2 reasons for this discrepancy: either the patient did not "recognize his own [[qualia|experience]] in the rather blunt, implicitly either/or formulation of the structured-interview question", or the [[qualia|experience]] did not "fully articulate itself" until the patient started talking about his experiences.<ref name = nordgaard1>{{cite journal | vauthors = Nordgaard J, Sass LA, Parnas J | title = The psychiatric interview: validity, structure, and subjectivity | journal = European Archives of Psychiatry and Clinical Neuroscience | volume = 263 | issue = 4 | pages = 353–364 | date = June 2013 | pmid = 23001456 | pmc = 3668119 | doi = 10.1007/s00406-012-0366-z | author-link2 = Louis Sass | author-link1 = Julie Nordgaard }}</ref>
===Obscuring root causes===
==== Economic causes ====
The DSM-5 has been criticized for overlooking [[capitalism]]’s interconnectivity with pathology.<ref>{{Cite journal |last=Olivier |first=B |date=2015 |title=Capitalism and suffering |url=http://ref.scielo.org/w7qdd5 |journal=Psychology in Society |volume=48 |pages=1–21 |doi=10.17159/2309-8708/2015/n48a1}}</ref> One example is the development and treatment of diagnoses: around 69% of psychiatrists involved in the development of the [[DSM-5]] were reported to have financial ties to the [[pharmaceutical industry]].<ref>{{Cite journal |last1=Cosgrove |first1=Lisa |last2=Wheeler |first2=Emily E |date=February 8, 2013 |title=Industry's colonization of psychiatry: Ethical and practical implications of financial conflicts of interest in the DSM-5 |url=http://journals.sagepub.com/doi/10.1177/0959353512467972 |journal=[[Feminism & Psychology]] |language=en |volume=23 |issue=1 |pages=93–106 |doi=10.1177/0959353512467972 |issn=0959-3535}}</ref> These ties situate many care services within the [[Medical–industrial complex|medical-industrial complex]], a framework that prioritizes profit instead of the care of individuals.<ref>{{Cite book |last=Magee |first=Mike |title=Code blue: inside America's medical industrial complex |publisher=[[Atlantic Monthly Press]] |year=2019 |isbn=978-0-8021-4687-8 |edition=1st |location=New York}}</ref> Lane found the [[Medical–industrial complex|medical-industrial complex]] intertwined with setting the parameters to diagnose conditions such as [[social anxiety disorder]].<ref>{{Cite book |last=Lane |first=Christopher |title=Shyness: how normal behavior became a sickness |date=2007 |publisher=Yale University Press |isbn=978-0-300-14317-1 |location=New Haven}}</ref> Other authors have supported similar findings.<ref>{{Cite book |last=Tone |first=Andrea |title=The Age of Anxiety: A History of America's Turbulent Affairs with Tranquilizers |date=January 3, 2012 |publisher=[[Basic Books]] |isbn=978-0465025206 |edition=1st |location=New York}}</ref><ref>{{Cite journal |last=Timler |first=Kelsey |date=2022 |title=Distorted Thinking or Distorted Realities? The Social Construction of Anxiety for Women in Neoliberal Late-Stage Capitalism |url=https://www.cambridge.org/core/product/identifier/S0887536722000605/type/journal_article |journal=Hypatia |language=en |volume=37 |issue=4 |pages=726–742 |doi=10.1017/hyp.2022.60 |issn=0887-5367}}</ref> Kincaid and Sullivan estimate that the cost of the industry surrounding diagnosis will rise to around six trillion dollars by 2030.<ref>{{Cite book |url=https://direct.mit.edu/books/book/3043/Classifying-PsychopathologyMental-Kinds-and |title=Classifying Psychopathology: Mental Kinds and Natural Kinds |date=2014-04-04 |publisher=The MIT Press |isbn=978-0-262-32243-0 |editor-last=Kincaid |editor-first=Harold |language=en |doi=10.7551/mitpress/8942.001.0001 |editor-last2=Sullivan |editor-first2=Jacqueline A.}}</ref>
Scholars differ in the extent of [[capitalism]]'s influence on diagnosis. Davies supports the [[social model of disability]] in explaining that diagnosis at present relies on considering conditions a consequence of a “broken brain.”<ref name=":10">{{Cite book |last=Davies |first=James |title=Sedated: How Modern Capitalism Created our Mental Health Crisis |date=March 3, 2022 |publisher=[[Atlantic Books]] |isbn=978-1786499875 |edition=1st |location=London}}</ref> His wider logic on mental illness in response to societal issues problematizes diagnosis as a tool of the [[Medical–industrial complex#:~:text=December 2022),and services for a profit.|medical-industrial complex]].<ref name=":10" /> His previous book, ''Cracked'', demonstrates the market interactions within the [[Medical–industrial complex#:~:text=December 2022),and services for a profit.|medical-industrial complex]], as diagnosis becomes a source for monetization.<ref>{{Cite book |last=Davies |first=James |title=Cracked: why psychiatry is doing more harm than good |date=2014 |publisher=[[Icon Books|Icon]] |isbn=978-1-84831-654-6 |location=London}}</ref>
Others find that the dependency of patients on their psychiatric care providers makes the industry vulnerable to economic exploitation under [[capitalism]].<ref name=":11">{{Cite journal |last=U'Ren |first=Richard |date=1997 |title=Psychiatry and Capitalism |url=https://www.jstor.org/stable/43853806 |journal=The Journal of Mind and Behavior |volume=18 |issue=1 |pages=1–11 |jstor=43853806 |issn=0271-0137}}</ref> These individuals argue that diagnosis is manipulated, but not caused, by capitalistic forces.<ref name=":11" /> Academics have critiqued the directness of the association between the [[medical model]], [[capitalism]], and diagnosis, but generally agree that characteristics of the capitalist system contribute to poor [[mental health]].<ref>{{Cite journal |last=Barney |first=Ken |date=1994 |title=Limitations of the Critique of the Medical Model |url=https://www.jstor.org/stable/43853630 |journal=The Journal of Mind and Behavior |volume=15 |issue=1/2 |pages=19–34 |jstor=43853630 |issn=0271-0137}}</ref>
==== Institutional causes ====
Diagnoses of mental conditions have been used to obscure institutional practices of [[discrimination]].<ref>{{Cite journal |last1=Lebowitz |first1=Matthew S. |last2=Ahn |first2=Woo-kyoung |date=2014-12-16 |title=Effects of biological explanations for mental disorders on clinicians' empathy |journal=Proceedings of the National Academy of Sciences |language=en |volume=111 |issue=50 |pages=17786–17790 |doi=10.1073/pnas.1414058111 |doi-access=free |issn=0027-8424 |pmc=4273344 |pmid=25453068|bibcode=2014PNAS..11117786L }}</ref> Late nineteenth-century diagnoses of white women with [[hysteria]], for instance, were said to be caused by “overcivilization,” shaped by racially discriminatory [[Social Darwinism]].<ref>{{Cite journal |last=Briggs |first=Laura |date=June 2000 |title=The Race of Hysteria: "Overcivilization" and the "Savage" Woman in Late Nineteenth-Century Obstetrics and Gynecology |url=https://muse.jhu.edu/article/2437 |journal=American Quarterly |language=en |volume=52 |issue=2 |pages=246–273 |doi=10.1353/aq.2000.0013 |pmid=16858900 |issn=1080-6490}}</ref> Similarly, American physician [[Samuel A. Cartwright|Samuel Cartwright]] coined "[[drapetomania]]" in 1851 as a mental condition which "caused" slaves to escape captivity.<ref>{{Cite book |last=Hogarth |first=Rana A. |title=Medicalizing blackness: making racial difference in the Atlantic world, 1780-1840 |date=2017 |publisher=The University of North Carolina Press |isbn=978-1-4696-3286-5 |location=Chapel Hill}}</ref> In the present day, Brinkmann finds that “contemporary diagnostic cultures,” whereby humans assess their conditions through a psychiatric lens, can “risk losing sight of the larger historical and social forces that affect [their] lives.”<ref name=":12">{{Cite book |last=Brinkmann |first=Svend |title=Diagnostic cultures: a cultural approach to the pathologization of modern life |date=2016 |publisher=Routledge, Taylor Francis Group |isbn=978-1-4724-1319-2 |series=Classical and contemporary social theory |location=London ; New York}}</ref> Contemporary diagnostic cultures help explain how diagnosis reflect larger historical biases.<ref name=":12" /><ref name=":13">{{Cite book |last=Metzl |first=Jonathan Michel |title=The protest psychosis: how schizophrenia became a black disease |date=2011 |publisher=Beacon |isbn=978-0-8070-0127-1 |location=Boston, Mass}}</ref>
Critics have argued that the DSM-5's criteria pathologize a wide range of people with distress or impairment. Chapman et al. discuss the implications for obscuring distress in the [[Imprisonment|incarceration and confinement]] of "intellectually disabled" populations; they argue that "differentiation based on [[Intellectual disability|psychiatric and intellectual disability]]" is arbitrarily set and altered based on [[capitalism]]'s needs for "mobile and free workers."<ref>{{Cite book |title=Disability incarcerated: imprisonment and disability in the United States and Canada |date=2014 |publisher=Palgrave Macmillan |isbn=978-1-137-39323-4 |editor-last=Ben-Moshe |editor-first=Liat |location=New York, NY |editor-last2=Carey |editor-first2=Allison C.}}</ref> Metzl demonstrates that the shifting diagnostic parameters of [[schizophrenia]] became a method for institutionalizing Black men during the [[Civil rights movement|Civil Rights Movement]].<ref name=":13" /> In sum, those who have experienced “domination” or “exploitation” based on an identity trait are more likely to be pathologized through diagnosis.<ref>{{Cite journal |last1=Prins |first1=Seth J. |last2=Bates |first2=Lisa M. |last3=Keyes |first3=Katherine M. |last4=Muntaner |first4=Carles |date=November 1, 2015 |title=Anxious? Depressed? You might be suffering from capitalism: contradictory class locations and the prevalence of depression and anxiety in the USA |journal=Sociology of Health & Illness |language=en |volume=37 |issue=8 |pages=1352–1372 |doi=10.1111/1467-9566.12315 |issn=0141-9889 |pmc=4609238 |pmid=26385581}}</ref>
===Overdiagnosis===
[[Allen Frances]], an outspoken critic of DSM-5, states that "normality is an endangered species," because of "fad diagnoses" and an "epidemic" of over-diagnosing, and suggests that the "DSM-5 threatens to provoke several more [epidemics]."<ref>{{Cite news|url=https://psychcentral.com/blog/overdiagnosis-mental-disorders-and-the-dsm-5/|title=Overdiagnosis, Mental Disorders and the DSM-5|date=2010-07-26|work=World of Psychology|access-date=2018-09-18|language=en-US}}</ref><ref>{{Cite web|url=https://www.psychologytoday.com/us/blog/dsm5-in-distress/201006/psychiatric-fads-and-overdiagnosis|title=Psychiatric Fads and Overdiagnosis|website=Psychology Today|language=en-US|access-date=2018-09-18}}</ref> Some researchers state that changes in diagnostic criteria, following each published version of the DSM, reduce thresholds for a diagnosis, which results in increases in prevalence rates for ADHD and [[Autism spectrum|autism spectrum disorder]].<ref>{{cite journal | vauthors = Thomas R, Mitchell GK, Batstra L | title = Attention-deficit/hyperactivity disorder: are we helping or harming? | journal = BMJ | volume = 347 | issue = nov05 1 | pages = f6172 | date = November 2013 | pmid = 24192646 | doi = 10.1136/bmj.f6172 | s2cid = 32080132 | url = http://www.bmj.com/cgi/content/short/348/jul01_1/g4377 }}</ref><ref name="bruchmuller 2012">{{cite journal | vauthors = Bruchmüller K, Margraf J, Schneider S | title = Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis | journal = Journal of Consulting and Clinical Psychology | volume = 80 | issue = 1 | pages = 128–138 | date = February 2012 | pmid = 22201328 | doi = 10.1037/a0026582 | s2cid = 6436414 }}</ref><ref>{{cite journal | vauthors = Vande Voort JL, He JP, Jameson ND, Merikangas KR | title = Impact of the DSM-5 attention-deficit/hyperactivity disorder age-of-onset criterion in the US adolescent population | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 53 | issue = 7 | pages = 736–744 | date = July 2014 | pmid = 24954823 | doi = 10.1016/j.jaac.2014.03.005 }}</ref><ref>{{cite journal | vauthors = Wing L, Potter D | title = The epidemiology of autistic spectrum disorders: is the prevalence rising? | journal = Mental Retardation and Developmental Disabilities Research Reviews | volume = 8 | issue = 3 | pages = 151–161 | date = 2002 | pmid = 12216059 | doi = 10.1002/mrdd.10029 }}</ref> Bruchmüller, et al. (2012) suggest that as a factor that may lead to overdiagnosis are situations when the clinical judgment of the diagnostician regarding a diagnosis (ADHD) is affected by [[heuristic]]s.<ref name="bruchmuller 2012"/>
===Dividing lines===
Despite caveats in the introduction to the DSM, it has long been argued that its [[Classification of mental disorders|system of classification]] makes unjustified categorical distinctions between disorders and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM [[syndromes]], or between a common DSM syndrome and normality, have failed.<ref name="concept&evolution"/> Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.<ref>{{cite web | vauthors = Spitzer RL, Williams JB, First MB, Gibbon M |title=Biometric Research |website= Psychiatric Institute 2001-2002 |publisher=New York State Psychiatric Institute |url=http://nyspi.org/AR2001/Biometrics.htm |archive-url=https://web.archive.org/web/20030307205740/http://nyspi.org/AR2001/Biometrics.htm |archive-date=7 March 2003 }}</ref><ref>{{cite journal | vauthors = Maser JD, Akiskal HS | title = Spectrum concepts in major mental disorders | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = xi–xiii | date = December 2002 | pmid = 12462854 | doi = 10.1016/S0193-953X(02)00034-5 }}</ref><ref>{{cite journal | vauthors = Krueger RF, Watson D, Barlow DH | title = Introduction to the special section: toward a dimensionally based taxonomy of psychopathology | journal = Journal of Abnormal Psychology | volume = 114 | issue = 4 | pages = 491–493 | date = November 2005 | pmid = 16351372 | pmc = 2242426 | doi = 10.1037/0021-843X.114.4.491 }}</ref>
In addition, it is argued that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.<ref>{{cite journal | vauthors = Wakefield JC, Schmitz MF, First MB, Horwitz AV | title = Extending the bereavement exclusion for major depression to other losses: evidence from the National Comorbidity Survey | journal = Archives of General Psychiatry | volume = 64 | issue = 4 | pages = 433–440 | date = April 2007 | pmid = 17404120 | doi = 10.1001/archpsyc.64.4.433 | doi-access = }}</ref> The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.
Because an individual's degree of impairment is often not correlated with symptom counts and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.<ref>{{cite journal | vauthors = Spitzer RL, Wakefield JC | title = DSM-IV diagnostic criterion for clinical significance: does it help solve the false positives problem? | journal = The American Journal of Psychiatry | volume = 156 | issue = 12 | pages = 1856–1864 | date = December 1999 | pmid = 10588397 | doi = 10.1176/ajp.156.12.1856 | s2cid = 25642814 }}</ref> On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life.
===Cultural bias===
Psychiatrists have argued that published diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.<ref name=Widiger2000/> Advocating a more [[culturally sensitive]] approach to psychology, critics such as [[Carl Bell (physician)|Carl Bell]] and Marcello Maviglia contend that researchers and service-providers often discount the cultural and ethnic diversity of individuals.<ref name="wash-post">{{cite news | vauthors = Vedantam S |date= June 26, 2005 |title = Psychiatry's Missing Diagnosis: Patients' Diversity Is Often Discounted |url= https://www.washingtonpost.com/wp-dyn/content/article/2005/06/25/AR2005062500982.html |newspaper= [[The Washington Post]] }}</ref> In addition, current diagnostic guidelines have been criticized<ref>{{cite journal | vauthors = Sashidharan SP, Francis E | title = Racism in psychiatry necessitates reappraisal of general procedures and Eurocentric theories | journal = BMJ | volume = 319 | issue = 7204 | pages = 254 | date = July 1999 | pmid = 10417096 | pmc = 1116337 | doi = 10.1136/bmj.319.7204.254 }}</ref> as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criterion-set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.<ref name="Widiger2000">{{cite journal | vauthors = Widiger TA, Sankis LM | title = Adult psychopathology: issues and controversies | journal = Annual Review of Psychology | volume = 51 | issue = 1 | pages = 377–404 | year = 2000 | pmid = 10751976 | doi = 10.1146/annurev.psych.51.1.377 }}</ref> [[Cross-cultural psychiatry|Cross-cultural]] psychiatrist [[Arthur Kleinman]] contends that Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.<ref>{{cite journal | vauthors = Kleinman A | title = Triumph or pyrrhic victory? The inclusion of culture in DSM-IV | journal = Harvard Review of Psychiatry | volume = 4 | issue = 6 | pages = 343–344 | year = 1997 | pmid = 9385013 | doi = 10.3109/10673229709030563 | s2cid = 43256486 }}</ref> Other cross-cultural critics largely share Kleinman's negative view toward the [[culture-bound syndrome]], common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.<ref>Bhugra, D. & Munro, A. (1997) ''Troublesome Disguises: Underdiagnosed Psychiatric Syndromes'' Blackwell Science Ltd {{ISBN missing|date=August 2016}}</ref>{{Page needed|date= August 2016}}
Mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.<ref name="Widiger2000" /> One result of this dissatisfaction was the development of the Azibo Nosology by Daudi Ajani Ya Azibo as an alternative to the DSM in treating patients of the [[African diaspora]].<ref>{{cite journal | vauthors = Irene A, Azibo DA | year = 1991 | title = Diagnosing personality disorder in Africans (Blacks) using the Azibo nosology: Two case studies | journal = Journal of Black Psychology | volume = 17 | issue = 2| pages = 1–22 | doi= 10.1177/00957984910172002|s2cid= 144458287 }}</ref><ref>{{cite journal | vauthors= ya Azibo DA |date= November 2014 |title= The Azibo Nosology II: Epexegesis and 25th Anniversary Update: 55 Culture-focused Mental Disorders Suffered by African Descent People |journal= Journal of Pan African Studies |volume= 7 |issue= 5 |pages= 32–176 |url= http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf |archive-url=https://web.archive.org/web/20151121133043/http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf |archive-date=2015-11-21 |url-status=live }}</ref><ref>{{cite journal | vauthors = Zulu IM |title= The Azibo Nosology: An Interview with Daudi Ajani ya Azibo |journal= Journal of Pan African Studies |volume= 7 |issue =5 |pages= 209–214 |url= http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf |archive-url=https://web.archive.org/web/20160820114756/http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf |archive-date=2016-08-20 |url-status=live }}</ref>
Historically, the DSM tended to avoid issues involving [[religion]]; the DSM-5 relaxed this attitude somewhat.<ref>
{{cite journal | vauthors = Chandler E | title = Religious and spiritual issues in DSM-5: matters of the mind and searching of the soul | journal = Issues in Mental Health Nursing | volume = 33 | issue = 9 | pages = 577–582 | date = September 2012 | pmid = 22957950 | doi = 10.3109/01612840.2012.704130 | quote = Given the important role that spirituality and religion play for many people in the experiences of coping with health and illness, it seems odd that such important elements are in the margins of the powerful and commanding nosology of the DSM. Explanations for understanding the glaring absence are complex and impacted by some very powerful political and sociological forces, including contributory elements from within the mental health disciplines. This article invites the reader to explore salient issues in the emergence of a broader recognition of religion, spirituality and psychiatric diagnosis in the DSM-5. | s2cid = 3453154 }}
</ref>
===Medicalization and financial conflicts of interest===
There was extensive analysis and comment on DSM-IV (published in 1994) in the years leading up to the 2013 publication of DSM-5. It was alleged that the way the categories of DSM-IV were structured, as well as the substantial expansion of the number of categories within it, represented increasing [[medicalization]] of human nature, very possibly attributable to [[disease mongering]] by psychiatrists and [[pharmaceutical companies]], the power and influence of the latter having grown dramatically in recent decades.<ref>Healy D (2006) [http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1 The Latest Mania: Selling Bipolar Disorder] {{webarchive|url=https://web.archive.org/web/20090212110644/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0030185&ct=1 |date=2009-02-12 }} PLoS Med 3(4): e185.</ref> In 2005, then APA President [[Steven Sharfstein]] released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".<ref>{{cite journal | vauthors = Cosgrove L, Krimsky S, Vijayaraghavan M, Schneider L | title = Financial ties between DSM-IV panel members and the pharmaceutical industry | journal = Psychotherapy and Psychosomatics | volume = 75 | issue = 3 | pages = 154–160 | date = 2006 | pmid = 16636630 | doi = 10.1159/000091772 | s2cid = 11909535 }}</ref> It was reported that of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had financial relationships with the pharmaceutical industry during the period 1989–2004, raising the prospect of a direct [[Conflict of interest#Relationship to medical research|conflict of interest]]. The same article concluded that the connections between panel members and the drug companies were particularly strong involving those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.
[[William Glasser]] referred to DSM-IV as having "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".<ref>{{cite web |url=http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html |title=(Susan Bowman, 2006) |publisher=The National Psychologist |date=2006-11-01 |access-date=2013-12-03 |archive-date=2017-06-26 |archive-url=https://web.archive.org/web/20170626220701/http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html }}</ref> A 2012 article in ''[[The New York Times]]'' commented sharply that DSM-IV (then in its 18th year), through copyrights held closely by the APA, had earned the Association over $100 million.<ref name="Greenberg">
{{cite news | url= https://www.nytimes.com/2012/01/30/opinion/the-dsms-troubled-revision.html | work= The New York Times | vauthors = Greenberg G | title = The D.S.M.'s Troubled Revision | date = January 29, 2012}} The article's closing words: "it [the APA] will be laughing all the way to the bank."</ref>
However, although the number of identified diagnoses had increased by more than 300% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argued that this almost entirely represented greater specification of the forms of pathology, thereby allowing better grouping of similar patients.<ref name="concept&evolution"/>
===Potential harm of labels===
A core function of the DSM is the categorization of people's experiences into diagnoses based on symptoms. However, there is disagreement about the use of diagnoses as labels. Some individuals are relieved to find they have a recognized condition that they can apply a name to, and this has led to many people [[Self-diagnosis|self-diagnosing]].<ref>{{Cite journal | vauthors = Giles DC, Newbold J |date= March 2011 |title=Self- and Other-Diagnosis in User-Led Mental Health Online Communities |url=http://journals.sagepub.com/doi/10.1177/1049732310381388 |journal=Qualitative Health Research |language=en |volume=21 |issue=3 |pages=419–428 |doi=10.1177/1049732310381388 |pmid= 20739589 |s2cid= 1853974 |issn=1049-7323}}</ref> Others, however, question the accuracy of diagnosis, or feel they have been given a label that invites [[social stigma]] and [[discrimination]] (the terms "[[mentalism (discrimination)|mentalism]]" and "sanism" have been used to describe such discriminatory treatment).<ref name="Sane">[http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf Sanism in Theory and Practice] {{Webarchive|url=https://web.archive.org/web/20140317045503/http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf |date=2014-03-17 }} May 9/10, 2011. Richard Ingram, Centre for the Study of Gender, Social Inequities and Mental Health. [[Simon Fraser University]], Canada</ref>
Diagnoses can become [[Internalization (psychology)|internalized]] and affect an individual's [[self-identity]], and some psychotherapists have found that the healing process can be inhibited and symptoms can worsen as a result.<ref>[http://jhp.sagepub.com/cgi/content/abstract/41/4/36 "How Using the Dsm Causes Damage: A Client's Report"] ''Journal of Humanistic Psychology'', Vol. 41, No. 4, 36–56 (2001)</ref> Some members of the [[psychiatric survivors movement]] (more broadly the consumer/survivor/ex-patient movement) actively campaign against their diagnoses, or the assumed implications, or against the DSM system in general.<ref name="CapeTown">{{cite web
| url=https://madpridect.wordpress.com/2013/06/08/known-as-the-psychiatric-bible-the-diagnostic-and-statistical-manual-of-mental-disorders-appears-in-a-fifth-edition/
| title=Known as the 'psychiatric bible', the Diagnostic and Statistical Manual of Mental Disorders appears in a fifth edition
| author=Cape Town Mad Pride
| author-link=Mad Pride
| access-date=28 Feb 2019
| date=2013-06-08
}}</ref><ref name="Medscape">
Michael T. Compton (2007) [http://www.medscape.com/viewarticle/565489_print Recovery: Patients, Families, Communities] Conference Report, Medscape Psychiatry & Mental Health, October 11–14, 2007
</ref> Additionally, it has been noted that the DSM often uses definitions and terminology that are inconsistent with a [[recovery model]], and such content can erroneously imply excess psychopathology (e.g. multiple "[[comorbid]]" diagnoses) or [[Chronic (medicine)|chronicity]].<ref name="Medscape"/>
===Critiques of DSM-5===
Psychiatrist [[Allen Frances]] has been critical of proposed revisions to the DSM–5. In a 2012 ''New York Times'' editorial, Frances warned that if this DSM version is issued unamended by the APA, "it will medicalize normality and result in a glut of unnecessary and harmful drug prescription."<ref name="nyt">{{cite news | vauthors = Frances A |date=11 May 2012 |url=https://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html |title=Diagnosing the D.S.M. |newspaper=New York Times |edition=New York |page=A19 }}</ref>
In a December 2012, blog post on ''[[Psychology Today]]'', Frances provides his "list of DSM 5's ten most potentially harmful changes:"<ref name="dsm5GuideNotBible">{{cite web| vauthors = Frances AJ |title=DSM 5 Is Guide Not Bible{{snd}}Ignore Its Ten Worst Changes: APA approval of DSM-5 is a sad day for psychiatry|url=http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes|access-date=2013-03-09|website=Psychology Today|date=December 2, 2012}}</ref>
* Disruptive Mood Dysregulation Disorder, for temper tantrums
* Major Depressive Disorder, includes normal grief
* Minor Neurocognitive Disorder, for normal forgetfulness in old age
* Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants
* Binge Eating Disorder, for excessive eating
* Autism, defining the disorder more specifically, possibly leading to decreased rates of diagnosis and the disruption of school services
* First-time drug users will be lumped in with addicts
* Behavioral Addictions, making a "mental disorder of everything we like to do a lot."
* Generalized Anxiety Disorder, includes everyday worries
* Post-traumatic stress disorder, changes "opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."<ref name="dsm5GuideNotBible" />
A group of 25 psychiatrists and researchers, among whom were Frances and [[Thomas Szasz]], have published debates on what they see as the six most essential questions in psychiatric diagnosis:<ref name="Phillips">{{cite journal | vauthors = Phillips J, Frances A, Cerullo MA, Chardavoyne J, Decker HS, First MB, Ghaemi N, Greenberg G, Hinderliter AC, Kinghorn WA, LoBello SG, Martin EB, Mishara AL, Paris J, Pierre JM, Pies RW, Pincus HA, Porter D, Pouncey C, Schwartz MA, Szasz T, Wakefield JC, Waterman GS, Whooley O, Zachar P | display-authors = 6 | title = The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis | journal = Philosophy, Ethics, and Humanities in Medicine | volume = 7 | issue = 1 | pages = 3 | date = January 2012 | pmid = 22243994 | pmc = 3305603 | doi = 10.1186/1747-5341-7-3 | doi-access = free }}</ref>
* Are they more like theoretical constructs or more like diseases?
* How to reach an agreed definition?
* Should the DSM-5 take a cautious or conservative approach?
* What is the role of practical rather than scientific considerations?
* How should it be used by clinicians or researchers?
* Is an entirely different diagnostic system required?
In 2011, psychologist [[Brent Robbins]] co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Over 15,000 individuals and [[mental health]] professionals have signed a petition in support of the letter.<ref name = "pointpark"/> Thirteen other APA divisions have endorsed the petition.<ref name = pointpark>{{cite web |url=http://www.pointpark.edu/NewsArtsSciences.aspx?id=467 |title=Professor co-authors letter about America's mental health manual |date=December 12, 2011 |work=Point Park University |access-date=2012-04-04 |archive-url=https://web.archive.org/web/20120329184708/http://www.pointpark.edu/NewsArtsSciences.aspx?id=467 |archive-date=2012-03-29 }}</ref> Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.<ref>{{cite news |url=http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/26/MNJJ1M3DFK.DTL |title=Revision of psychiatric manual under fire| vauthors = Allday E |date=November 26, 2011 |work=San Francisco Chronicle }}</ref>
== See also ==
{{col div|colwidth=30em}}
* [[Chinese Classification and Diagnostic Criteria of Mental Disorders]]
* [[Classification of mental disorders]]
* [[Diagnostic classification and rating scales used in psychiatry]]
* [[DSM-IV Codes]]
* [[Global Assessment of Functioning|Global Assessment of Functioning (GAF) Scale]]
* [[International Statistical Classification of Diseases and Related Health Problems|International Statistical Classification of Diseases and Related Health Problems (ICD)]]
* [[Kraepelinian dichotomy]]
* [[Psychodynamic Diagnostic Manual]]
* [[Relational disorder]] (proposed DSM-5 new diagnosis)
* [[Research Domain Criteria]] (RDoC), a framework being developed by the National Institute of Mental Health
* [[Rosenhan experiment]]
* [[Structured Clinical Interview for DSM-IV]] ''(SCID)''
* [[Homosexuality in DSM]]
{{colend}}
== Notes ==
{{Notelist}}
== References ==
{{Reflist|30em}}
== Further reading ==
{{refbegin}}
* {{cite book| author = American Psychiatric Association| title = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®| url = https://books.google.com/books?id=3SQrtpnHb9MC| year = 2000| publisher = American Psychiatric Pub| isbn = 978-0-89042-025-6 }}
* {{cite book| vauthors = Spitzer RL | title = Dsm-Iv-Tr Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders| url = https://books.google.com/books?id=S_xe-AX4UjMC| year = 2002| publisher = American Psychiatric Pub| isbn = 978-1-58562-059-3 }}
{{refend}}
== External links ==
* [http://www.dsm5.org/pages/default.aspx Official DSM-5 development website]
* [http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm Diagnostic Criteria from DSM-IV-TR]{{dead link|date=December 2021|bot=medic}}{{cbignore|bot=medic}}
* [https://archive.today/20120527015056/http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm Diagnostic Criteria from DSM-IV-TR]
* [https://apicalhealth.com/illness-and-recovery/dsm-iv/ The Multiaxial System of Diagnosis in DSM-IV Criteria] {{Webarchive|url=https://web.archive.org/web/20210116142849/https://apicalhealth.com/illness-and-recovery/dsm-iv/ |date=2021-01-16 }}
{{DSM personality disorders}}
{{Medical classification}}
{{italic title}}
[[Category:Diagnostic and Statistical Manual of Mental Disorders| ]]
[[Category:American Psychiatric Association]]
[[Category:Data coding framework]]
[[Category:Medical manuals]]
[[Category:Medical statistics]]
[[Category:Psychiatric assessment]]
[[Category:Classification of mental disorders]]
[[Category:Psychiatric diagnosis]]
[[Category:Psychopathology]]
[[Category:Publications established in 1952]]
[[Category:Statistical data coding]]' |
New page wikitext, after the edit (new_wikitext) | '{{Short description|American psychiatric classification}}
{{Use mdy dates|date=February 2024}} {{Use American English|date=February 2024}}
[[File:DiagnosticAndStatisticalManualOfMentalDisorders.jpg|thumb|1952 edition of the DSM (DSM-I)]]
The '''''Diagnostic and Statistical Manual of Mental Disorders''''' ('''''DSM'''''; latest edition: ''[[DSM-5-TR]]'', published in March 2022<ref name=":1">{{Cite web|title=DSM-5 Full Text Online|url=http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf|access-date=10 January 2022|via=Archive.Today}}</ref>) is a publication by the [[American Psychiatric Association]] (APA) for the [[classification of mental disorders]] using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the [[United States]] and [[Australia]],<ref>{{Cite web |date=2021-04-30 |title=How Australia adopted America's bible of psychiatry |url=https://www.afr.com/policy/health-and-education/how-australia-adopted-america-s-bible-of-psychiatry-20210419-p57kjr |access-date=2024-01-24 |website=Australian Financial Review |language=en}}</ref> while in other countries it may be used in conjunction with other documents. The DSM-5 is considered one of the principal guides of psychiatry, along with the [[International Classification of Diseases]] (ICD), [[Chinese Classification of Mental Disorders]] (CCMD), and the ''[[Psychodynamic Diagnostic Manual]]''. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world<ref name ="Do mental health professionals use diagnostic classifications the way we think they do? A global survey">{{Cite journal|vauthors=First M, Rebello T, Keeley J, Bhargava R, Dai Y, Kulygina M, Matsumoto C, Robles R, Stona A, Reed G |title=Do mental health professionals use diagnostic classifications the way we think they do? A global survey|journal=World Psychiatry|language=en|volume=17|issue=2|pages=187–195|pmid = 29856559| date = June 2018 | doi=10.1002/wps.20525|pmc=5980454 }}</ref> and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.<ref name = "Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis">{{Cite journal|vauthors = Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JP, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JP, Geddes JR | title = Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis | journal = The Lancet | date = 7 April 2018 | volume = 391 | issue = 10128 | pages = 1357–1366 | doi = 10.1016/S0140-6736(17)32802-7 | pmid = 29477251 | pmc = 5889788 }}</ref><ref>{{cite journal | vauthors=Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D | journal=International Clinical Psychopharmacology | title=Efficacy of treatments for anxiety disorders: a meta-analysis | volume=30 | issue=4 | pages=183–192 | date= July 2015 | issn=0268-1315 | doi=10.1097/YIC.0000000000000078| pmid=25932596 | s2cid=24088074 }}</ref><ref>{{cite journal | vauthors=Schneider-Thoma J, Chalkou K, Dörries C, Bighelli I, Ceraso A, Huhn M, Siafis S, Davis JM, Cipriani A, Furukawa TA, Salanti G, Leucht S | journal=Lancet | title=Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis | volume=399 | issue=10327 | date=26 February 2022 | pages=824–836 | issn=0140-6736 | doi=10.1016/S0140-6736(21)01997-8 | pmid=35219395 | s2cid=247087411 | doi-access=free }}</ref><ref>{{cite journal | vauthors=Gartlehner G, Crotty K, Kennedy S, Edlund MJ, Ali R, Siddiqui M, Fortman R, Wines R, Persad E, Viswanathan M | journal=CNS Drugs | title=Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis | volume=35 | issue=10 | pages=1053–1067 | date= October 2021 | issn=1172-7047 | doi=10.1007/s40263-021-00855-4| pmid=34495494 | pmc=8478737 }}</ref>
It is used by researchers, [[psychiatric drug]] regulation agencies, [[health insurance]] companies, [[pharmaceutical companies]], the legal system, and policymakers. Some mental health professionals use the manual to determine and help communicate a patient's diagnosis after an evaluation. Hospitals, clinics, and insurance companies in the United States may require a DSM diagnosis for all patients with mental disorders. Health-care researchers use the DSM to categorize patients for research purposes.
The DSM evolved from systems for collecting census and [[psychiatric hospital]] statistics, as well as from a [[United States Army]] manual. Revisions since its first publication in 1952 have incrementally added to the total number of [[mental disorders]], while removing those no longer considered to be mental disorders.
Recent editions of the DSM have received praise for standardizing psychiatric diagnosis grounded in empirical evidence, as opposed to the theory-bound [[nosology]] (the branch of [[medical science]] that deals with the [[Medical classification|classification of diseases]]) used in DSM-III.{{Citation needed|reason=Reads as more of a marketing statement than academically sound claim. A citation from the APA declaring itself to be an authority would not be sufficient backing for this claim.|date=April 2023}} However, it has also generated [[#Criticisms|controversy and criticism]], including ongoing questions concerning the [[Reliability (statistics)|reliability]] and [[Validity (statistics)|validity]] of many diagnoses; the use of arbitrary dividing lines between mental illness and "[[Normality (behavior)|normality]]"; possible [[cultural bias]]; and the [[medicalization]] of human distress.<ref name="frana">{{cite web |url=http://annals.org/article.aspx?articleid=1688399 |title=The New Crisis in Confidence in Psychiatric Diagnosis | vauthors = Frances A |date=17 May 2013 |work=Annals of Internal Medicine |author-link=Allen Frances }}</ref><ref name="concept&evolution">{{cite journal | vauthors = Dalal PK, Sivakumar T | title = Moving towards ICD-11 and DSM-V: Concept and evolution of psychiatric classification | journal = Indian Journal of Psychiatry | volume = 51 | issue = 4 | pages = 310–319 | year = 2009 | pmid = 20048461 | pmc = 2802383 | doi = 10.4103/0019-5545.58302 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Kendell R, Jablensky A | title = Distinguishing between the validity and utility of psychiatric diagnoses | journal = The American Journal of Psychiatry | volume = 160 | issue = 1 | pages = 4–12 | date = January 2003 | pmid = 12505793 | doi = 10.1176/appi.ajp.160.1.4 | s2cid = 16151623 }}</ref><ref>{{cite journal | vauthors = Baca-Garcia E, Perez-Rodriguez MM, Basurte-Villamor I, Fernandez del Moral AL, Jimenez-Arriero MA, Gonzalez de Rivera JL, Saiz-Ruiz J, Oquendo MA | display-authors = 6 | title = Diagnostic stability of psychiatric disorders in clinical practice | journal = The British Journal of Psychiatry | volume = 190 | issue = 3 | pages = 210–216 | date = March 2007 | pmid = 17329740 | doi = 10.1192/bjp.bp.106.024026 | s2cid = 4888348 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Pincus HA, Zarin DA, First M | title = 'Clinical significance' and DSM-IV | journal = Archives of General Psychiatry | volume = 55 | issue = 12 | pages = 1145; author reply 1147–1145; author reply 1148 | date = December 1998 | pmid = 9862559 | doi = 10.1001/archpsyc.55.12.1145 | url = http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145 | archive-url = https://web.archive.org/web/20070929134334/http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145 | archive-date = 2007-09-29 }}</ref> The APA itself has published that the inter-rater reliability is low for many disorders in the DSM-5, including [[major depressive disorder]] and [[generalized anxiety disorder]].<ref name ="DSM-5 Field Trials in the United States and Canada, Part II: Test-Retest Reliability of Selected Categorical Diagnoses">{{Cite journal | vauthors = Regier D, Narrow W, Clarke D, Kraemer H, Kuramoto S, Kuhl E, Kupfer D|title=DSM-5 Field Trials in the United States and Canada, Part II: Test-Retest Reliability of Selected Categorical Diagnoses|journal=American Journal of Psychiatry|volume=170|issue=1|pages=59–70|doi=10.1176/appi.ajp.2012.12070999|year=2013|pmid=23111466 }}</ref>
==Distinction from ICD==
An alternate, widely used classification publication is the ''[[International Statistical Classification of Diseases and Related Health Problems|International Classification of Diseases]]'' (ICD) is produced by the [[World Health Organization]] (WHO).<ref>''[[ICD-10|ICD-10 Classification of Mental and Behavioural Disorders]]:''
"[https://www.who.int/classifications/icd/en/bluebook.pdf Clinical descriptions and diagnostic guidelines]" (aka the "Blue Book"); and
"[https://www.who.int/classifications/icd/en/GRNBOOK.pdf Diagnostic criteria for research]" (aka the "Green Book").</ref> The ICD has a broader scope than the DSM, covering overall health as well as mental health; chapter 5 of the ICD specifically covers mental and behavioral disorders. Moreover, while the DSM is the most popular diagnostic system for mental disorders in the US, the ICD is used more widely in Europe and other parts of the world, giving it a far larger reach than the DSM. An international survey of psychiatrists in sixty-six countries compared the use of the [[ICD-10]] and DSM-IV. It found the former was more often used for clinical diagnosis while the latter was more valued for research.<ref>{{cite journal |vauthors=Mezzich JE |year=2002 |title=International surveys on the use of ICD-10 and related diagnostic systems |journal=Psychopathology |volume=35 |issue=2–3 |pages=72–75 |doi=10.1159/000065122 |pmid=12145487 |s2cid=35857872}}</ref> This may be because the DSM tends to put more emphasis on clear diagnostic criteria, while the ICD tends to put more emphasis on clinician judgement and avoiding diagnostic criteria unless they are independently validated. That is, the ICD descriptions of psychiatric disorders tend to be more qualitative information, such as general descriptions of what various disorders tend to look like. The DSM focuses more on quantitative and operationalized criteria; e.g. to be diagnosed with X disorder, one must fulfill 5 of 9 criteria for at least 6 months.<ref name=":2">{{Cite journal |last=Tyrer |first=Peter |date=2014 |title=A comparison of DSM and ICD classifications of mental disorder |journal=Advances in Psychiatric Treatment |language=en |volume=20 |issue=4 |pages=280–285 |doi=10.1192/apt.bp.113.011296 |issn=1355-5146|doi-access=free }}</ref>
The [[DSM-IV-TR codes|DSM-IV-TR]] (4th ed.) contains specific codes allowing comparisons between the DSM and the ICD manuals, which may not systematically match because revisions are not simultaneously coordinated.<ref>In Appendix G: "ICD-9-CM Codes for Selected General Medical Conditions and Medication-Induced Disorders"</ref> Though recent editions of the DSM and ICD have become more similar due to collaborative agreements, each one contains information absent from the other.<ref>{{cite journal | author = American Psychological Association | year = 2009 | title = ICD VS. DSM | url = http://www.apa.org/monitor/2009/10/icd-dsm.aspx | journal = Monitor on Psychology | volume = 40 | issue = 9|page = 63 }}</ref> For instance, the two manuals contain overlapping but substantially different lists of recognized [[culture-bound syndrome]]s.<ref>[https://www.who.int/entity/classifications/icd/en/GRNBOOK.pdf Diagnostic criteria for research], p. 213–225 ([[World Health Organization|WHO]] 1993)</ref> The ICD also tends to focus more on primary-care and low and middle-income countries, as opposed to the DSM's focus on secondary psychiatric care in high-income countries.<ref name=":2" />
==Antecedents (1840–1949)==
===Census Office, AMA and ISI (1840–1911)===
The initial impetus for developing a classification of mental disorders in the United States was the need to collect statistical information. The first official attempt was the [[United States census, 1840|1840 census]], which used a single category: "[[idiocy]]/[[insanity]]". Three years later, the [[American Statistical Association]] made an official protest to the [[U.S. House of Representatives]], stating that "the most glaring and remarkable errors are found in the statements respecting [[nosology]], prevalence of insanity, blindness, deafness, and dumbness, among the people of this nation", pointing out that in many towns [[African Americans]] were all marked as insane, and calling the statistics essentially useless.<ref>{{cite journal | vauthors = Gorwitz K | title = Census enumeration of the mentally ill and the mentally retarded in the nineteenth century | journal = Health Services Reports | volume = 89 | issue = 2 | pages = 180–187 | date = March–April 1974 | pmid = 4274650 | pmc = 1616226 | doi = 10.2307/4595007 | jstor = 4595007 }}</ref>
The [[Association of Medical Superintendents of American Institutions for the Insane]] ("The Superintendents' Association") was formed in 1844.<ref>{{Cite journal |date=1976 |title=The original thirteen |journal=Hospital & Community Psychiatry |volume=27 |issue=7 |pages=464–467 |issn=0022-1597 |pmid=776775}}</ref>
In 1860, during the international statistical congress held in London, [[Florence Nightingale]] made a proposal that was to result in the development of the first international model of systematic collection of hospital data.
In 1872, the [[American Medical Association]] (AMA) published its ''Nomenclature of Diseases'', which included various "Disorders of the Intellect".<ref>{{Cite web |title=A nomenclature of diseases: with the reports of the majority and of the minority of the committee thereon: presented to the American Medical Association at the meeting held in Philadelphia, May 1872 |url=https://collections.nlm.nih.gov/catalog/nlm:nlmuid-31910070R-bk |access-date=2022-11-06 |website=Digital Collections – National Library of Medicine |page=53}}</ref> Its use was short-lived however.<ref>{{Cite book |url=https://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf |archive-url=https://web.archive.org/web/20110505192204/http://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf |archive-date=2011-05-05 |url-status=live |title=History of the Statistical Classification of Diseases and Causes of Death |publisher=National Centre for Health Statistics |year=2011}}</ref>
Edward Jarvis and later [[Francis Amasa Walker]] helped expand the census, from two volumes in 1870 to twenty-five volumes in 1880.<ref>{{Cite journal |vauthors=Grob GN |date=1976 |title=Edward Jarvis and the Federal Census: A Chapter in the History of Nineteenth-Century American Medicine |journal=Bulletin of the History of Medicine |publisher=The Johns Hopkins University Press |volume=50 |issue=1 |pages=4–27 |jstor=44450311 |pmid=769874 }}</ref>
In 1888, the [[United States Census Bureau|Census Office]] published Frederick H. Wines' 582-page volume called ''Report on the Defective, Dependent, and Delinquent Classes of the Population of the United States, As Returned at the Tenth Census (June 1, 1880)''. Wines used seven categories of mental illness, which were also adopted by the Superintendents: [[dementia]], [[dipsomania]] (uncontrollable craving for alcohol), [[epilepsy]], [[mania]], [[melancholia]], [[monomania]], and [[paresis]].<ref>[https://sites.google.com/site/psych54000/a History of the DSM] {{Webarchive|url=https://web.archive.org/web/20130911021653/https://sites.google.com/site/psych54000/a |date=2013-09-11 }} Nathaniel Deyoung, Purdue University. Retrieved 9 Sept 2013</ref>
In 1892, the Superintendents' Association expanded its membership to include other mental health workers, and renamed to the [[American Psychiatric Association|American Medico-Psychological Association]] (AMPA).<ref>{{Cite book |title=The history and influence of the American Psychiatric Association |vauthors=Barton WE |date=1987 |publisher=American Psychiatric Press |others=American Psychiatric Association |isbn=0-88048-231-1 |location=Washington, D.C. |page=89 |oclc=13945621}}</ref>
In 1893, a French physician, [[Jacques Bertillon]], introduced the ''Bertillon Classification of Causes of Death'' at a congress of the [[International Statistical Institute]] (ISI) in Chicago.<ref>[https://archive.org/search.php?query=%28%28subject%3A%22Bertillon%2C%20Jacques%22%20OR%20subject%3A%22Jacques%20Bertillon%22%20OR%20creator%3A%22Bertillon%2C%20Jacques%22%20OR%20creator%3A%22Jacques%20Bertillon%22%20OR%20creator%3A%22Bertillon%2C%20J%2E%22%20OR%20title%3A%22Jacques%20Bertillon%22%20OR%20description%3A%22Bertillon%2C%20Jacques%22%20OR%20description%3A%22Jacques%20Bertillon%22%29%20OR%20%28%221851-1922%22%20AND%20Bertillon%29%29%20AND%20%28-mediatype:software%29 Works of Jacques Bertillon], Internet Archive.</ref><ref name="History">{{cite web |title=''History of the development of the ICD''. |url=https://www.who.int/entity/classifications/icd/en/HistoryOfICD.pdf |access-date=11 December 2017 |website=Who.int}}</ref> (The ISI had commissioned him to create it in 1891).<ref name="History" /> A number of countries adopted the ISI's system. In 1898, the [[American Public Health Association]] (APHA) recommended that United States registrars also adopt the system.<ref name="History" />
In 1900, an ISI conference in Paris reformed the Bertillion Classification, and created the ''[[International Classification of Diseases|International List of Causes of Death]]'' (ILCD)''.<ref name="History" />'' Another conference would be held every ten years, and a new edition of the ILCD would be released. Five were ultimately issued. Non-fatal conditions were not included.
In 1903, New York's [[Bellevue Hospital]] published "The Bellevue Hospital nomenclature of diseases and conditions", which included a section on "Diseases of the Mind". Revisions were released in 1909 and 1911. It was produced with the assistance of the AMA and Bureau of the Census.<ref>{{Cite book |url=https://wellcomecollection.org/works/u4swa3m3/ |title=The Bellevue Hospital nomenclature of diseases and conditions |publisher=Bellvue and Allied Hospitals |year=1911 |edition=3rd |location=New York}}</ref>
===APA Statistical Manual (1917) and AMA Standard (1933)===
In 1917, together with the National Commission on Mental Hygiene (now [[Mental Health America]]), the American Medico-Psychological Association developed a new guide for mental hospitals called the ''Statistical Manual for the Use of Institutions for the Insane''. This guide included twenty-two diagnoses. It would be revised several times by the Association, and by the tenth edition in 1942, was titled ''Statistical Manual for the Use of Hospitals of Mental Diseases''.<ref>[https://archive.org/details/statisticalmanu00assogoog Statistical manual for the use of institutions for the insane (1918)] University of Michigan via Internet Archive</ref><ref>{{cite journal | vauthors = Clark LA, Cuthbert B, Lewis-Fernández R, Narrow WE, Reed GM | title = Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health's Research Domain Criteria (RDoC) | journal = Psychological Science in the Public Interest | volume = 18 | issue = 2 | pages = 72–145 | date = September 2017 | pmid = 29211974 | doi = 10.1177/1529100617727266 | s2cid = 206743519 | doi-access = free }}</ref>
In 1921, the AMPA became the present [[American Psychiatric Association]] (APA).<ref>{{Cite book |title=The history and influence of the American Psychiatric Association |vauthors=Barton WE |date=1987 |publisher=American Psychiatric Press |others=American Psychiatric Association |isbn=0-88048-231-1 |location=Washington, D.C. |pages=168 |oclc=13945621}}</ref>
The first edition of the DSM notes in its foreword: "In the late twenties, each large teaching center employed a system of its own origination, no one of which met more than the immediate needs of the local institution."<ref name=":8">{{cite web | url=https://archive.org/details/dsm-1 | title=DSM-1 Full PDF | year=1952 }}</ref>
In 1933, the AMA's general medical guide the ''Standard Classified Nomenclature of Disease'', (referred to as the ''Standard),'' was released.<ref>{{Cite journal |date=December 1933 |title=A Standard Classified Nomenclature of Disease |url=https://journals.lww.com/jonmd/Citation/1933/12000/A_Standard_Classified_Nomenclature_of_Disease.75.aspx |journal=The Journal of Nervous and Mental Disease |language=en-US |volume=78 |issue=6 |page=679 |doi=10.1097/00005053-193312000-00075 |issn=0022-3018|last1=Logie |first1=H. B. |doi-access=free }}</ref> Along with the [[New York Academy of Medicine]], the APA provided the psychiatric [[nomenclature]] subsection.<ref>{{cite journal | vauthors = Greenberg SA, Shuman DW, Meyer RG | title = Unmasking forensic diagnosis | journal = International Journal of Law and Psychiatry | volume = 27 | issue = 1 | pages = 1–15 | year = 2004 | pmid = 15019764 | doi = 10.1016/j.ijlp.2004.01.001 }}</ref> It became well adopted in the US within two years.<ref name=":8" /> A major revision of the Statistical Manual was made in 1934, to bring it in line with the new Standard.<ref name=":8" /> A number of revisions of the Standard were produced, with the last in 1961.<ref>{{Cite book |title=Standard nomenclature of diseases and operations |publisher=McGraw Hill |year=1961 |editor-last=Thompson |editor-first=ET |edition=5th |location=New York |editor-last2=Hayden |editor-first2=AC}}</ref>
===Medical 203 (1945)===
[[World War II]] saw the large-scale involvement of U.S. psychiatrists in the selection, processing, assessment, and treatment of soldiers.<ref>{{Cite book |last= |first= |url=https://books.google.com/books?id=BHEwAAAAIAAJ |title=The Medical Department of the United States Army in World War II. |collaboration=United States Army Medical Service |date=1966 |publisher=Office of the Surgeon General, Department of the Army |page=756 |language=en}}</ref> This moved the focus away from mental institutions and traditional clinical perspectives. The U.S. armed forces initially used the Standard, but found it lacked appropriate categories for many common conditions that troubled troops. The [[US Navy|United States Navy]] made some minor revisions but "the Army established a much more sweeping revision, abandoning the basic outline of the Standard and attempting to express present-day concepts of mental disturbance."<ref name=":8" />
Under the direction of [[James Forrestal]],<ref name="NavyPsyc2">{{cite web |vauthors=Sobocinski A |title=A Brief History of U.S. Navy Psychiatric Diagnoses, Part II |url=https://navymedicine.navylive.dodlive.mil/archives/7192 |website=Navy Medicine Live |publisher=U.S. Navy Bureau of Medicine and Surgery |access-date=28 April 2020 |archive-date=20 April 2020 |archive-url=https://web.archive.org/web/20200420113904/https://navymedicine.navylive.dodlive.mil/archives/7192 }}</ref> a committee headed by psychiatrist [[Brigadier General (United States)|Brigadier General]] [[William C. Menninger]], with the assistance of the Mental Hospital Service,<ref>{{Cite journal |pmc = 2015553|year = 1953| vauthors = Sandison RA, Spencer AM |title = Mental Hospital Service|journal = British Medical Journal|volume = 1|issue = 4809|pages = 560|doi = 10.1136/bmj.1.4809.560}}</ref> developed a new classification scheme in 1944 and 1945.
Issued in War Department Technical Bulletin, Medical, 203 (TB MED 203); ''Nomenclature and Method of Recording Diagnoses'' was released shortly after the war in October 1945 under the auspices of the [[Office of the Surgeon General]].<ref name="Houts2000">{{cite journal | vauthors = Houts AC | title = Fifty years of psychiatric nomenclature: reflections on the 1943 War Department Technical Bulletin, Medical 203 | journal = Journal of Clinical Psychology | volume = 56 | issue = 7 | pages = 935–967 | date = July 2000 | pmid = 10902952 | doi = 10.1002/1097-4679(200007)56:7<935::AID-JCLP11>3.0.CO;2-8 | url = http://www3.interscience.wiley.com/journal/72506618/abstract | archive-url = https://archive.today/20130105054908/http://www3.interscience.wiley.com/journal/72506618/abstract | archive-date = 2013-01-05 }}</ref> It was reprinted in the [[Journal of Clinical Psychology]] for civilian use in July 1946 with the new title ''Nomenclature of Psychiatric Disorders and Reactions''.<ref>{{Cite journal |date=July 1946 |title=Nomenclature of psychiatric disorders and reactions |url=https://onlinelibrary.wiley.com/doi/10.1002/1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O |journal=[[Journal of Clinical Psychology]] |volume=2 |issue=3 |pages=289–296|doi=10.1002/1097-4679(194607)2:3<289::AID-JCLP2270020316>3.0.CO;2-O |pmid=20992064 }}</ref> This system came to be known as "Medical 203".
This nomenclature eventually was adopted by all the armed forces, and "assorted modifications of the Armed Forces nomenclature [were] introduced into many clinics and hospitals by psychiatrists returning from military duty."<ref name=":8" /> The [[United States Department of Veterans Affairs|Veterans Administration]] also adopted a slightly modified version of the standard in 1947.<ref name="NavyPsyc2" />
The further developed ''Joint Armed Forces Nomenclature and Method of Recording Psychiatric Conditions'' was released in 1949.<ref>{{Cite book |last=U.S. Army. U.S. Navy. U.S. Air Force |url=http://archive.org/details/NOMENCLATUREANDMETHODOFRECORDINGPSYCHIATRICCONDITIONS |title=Joint Armed Forces Nomenclature and Method of Recording Psychiatric Conditions |date=1949}}</ref>
===ICD-6 (1948)===
In 1948, the newly formed [[World Health Organization]] took over the maintenance of the ILCD. They greatly expanded it, included non-fatal conditions for the first time, and renamed it the ''[[International Statistical Classification of Diseases]]'' (ICD). The foreword to the DSM-I states the ICD-6 "categorized mental disorders in rubrics similar to those of the Armed Forces nomenclature."<ref name=":8" />
== Early versions (20th century) ==
===DSM-I (1952)===
The APA Committee on Nomenclature and Statistics was empowered to develop a version of Medical 203 specifically for use in the United States, to standardize the diverse and confused usage of different documents. In 1950, the APA committee undertook a review and consultation. It circulated an adaptation of Medical 203, the ''Standard''{{'}}s nomenclature, and the VA system's modifications of the ''Standard'' to approximately 10% of APA members. 46% of members replied, with 93% approving the changes. After some further revisions, the ''Diagnostic and Statistical Manual of Mental Disorders'' was approved in 1951 and published in 1952. The structure and conceptual framework were the same as in Medical 203, and many passages of text were identical.<ref name="Houts2000"/> The manual was 130 pages long and listed 106 mental disorders.<ref>{{cite journal | vauthors = Grob GN | title = Origins of DSM-I: a study in appearance and reality | journal = The American Journal of Psychiatry | volume = 148 | issue = 4 | pages = 421–431 | date = April 1991 | pmid = 2006685 | doi = 10.1176/ajp.148.4.421 }}</ref> These included several categories of "personality disturbance", generally distinguished from "neurosis" (nervousness, [[egodystonic]]).<ref name="Oldham">{{cite journal| vauthors = Oldham JM |title=Personality Disorders|journal=FOCUS|year=2005|volume=3|pages=372–382|url=http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21|archive-url=https://archive.today/20120720080755/http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21|archive-date=2012-07-20}}</ref>
The foreword to this edition describes itself as being a continuation of the ''Statistical Manual for the Use of Hospitals of Mental Diseases.<ref name=":8" />'' Each item was given an ICD-6 equivalent code, where applicable.
[[File:Statistical card for use in hospitals for mental illness.jpg|thumb]]
The DSM-I centers around three classes of symptoms: psychotic, neurotic, and behavioral.<ref name=":9">{{Cite web |date=1952 |title=Diagnostic and Statistical Manual |url=http://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf |access-date=April 25, 2023 |website=American Psychiatric Association |publisher=The Committee on Nomenclature and Statistics}}</ref> Within each class of mental disorder, classifying information is provided to differentiate conditions with similar symptoms. Under each broad class of disorder (e.g. "Psychoneurotic Disorders" or "Personality Disorders"), all possible diagnoses are listed, generally from least to most severe.<ref name=":9" /> The 1952 DSM version also includes sections detailing how to record patients' disorders along with their demographic details.<ref name=":9" /> The form includes information like a patient's area of residence, admission status, discharge date/condition, and severity of disorder.<ref name=":9" /> See Figure 1. for the form that psychiatrists were asked to utilize for recording preliminary diagnostic information.<ref name=":9" />
Furthermore, the APA listed homosexuality in the DSM as a [[Antisocial personality disorder|sociopathic]] personality disturbance. ''[[Homosexuality: A Psychoanalytic Study of Male Homosexuals]]'', a large-scale 1962 study of homosexuality by [[Irving Bieber]] and other authors, was used to justify inclusion of the disorder as a supposed pathological hidden fear of the opposite sex caused by traumatic parent–child relationships. This view was influential in the medical profession.<ref name=":0">{{Cite book| vauthors = Edsall NC |title=Toward Stonewall: Homosexuality and Society in the Modern Western World|publisher=University of Virginia Press|year=2003}}</ref> In 1956, however, the psychologist [[Evelyn Hooker]] performed a study comparing the happiness and well-adjusted nature of self-identified homosexual men with heterosexual men and found no difference.<ref name=":0" /> Her study stunned the medical community and made her a heroine to many gay men and lesbians,<ref>{{Cite book | vauthors = Marcus E |title=Making Gay History |publisher=Harper Collins |year=2009 |location=Print |pages=58–59}}</ref> but homosexuality remained in the DSM until May 1974.<ref>{{cite book|chapter-url=https://books.google.com/books?id=drBejRLWkHkC&pg=PA76 |chapter=The Transformation of Mental Disorders in the 1980s: The DSM-III, Managed Care, and "Cosmetic Psychopharmacology" |page=76 |title=Medicating Children: ADHD and Pediatric Mental Health | vauthors = Mayes R, Bagwell C, Erkulwater JL |publisher=Harvard University Press |date= 2009 |access-date=2013-12-03 |isbn=978-0-674-03163-0 }}</ref>
===DSM-II (1968)===
In the 1960s, there were many challenges to the concept of [[mental illness]] itself. These challenges came from psychiatrists like [[Thomas Szasz]], who argued mental illness was a myth used to disguise moral conflicts; from sociologists such as [[Erving Goffman]], who said mental illness was another example of how society labels and controls non-conformists; from [[behavioural psychologist]]s who challenged psychiatry's fundamental reliance on unobservable phenomena; and from gay rights activists who criticised the APA's listing of homosexuality as a mental disorder.
The APA was closely involved in the next significant revision of the mental disorder section of the ICD (version 8 in 1968). It decided to go ahead with a revision of the DSM, which was published in 1968. DSM-II was similar to DSM-I, listed 182 disorders, and was 134 pages long. The term "reaction" was dropped, but the term "[[neurosis]]" was retained. Both the DSM-I and the DSM-II reflected the predominant [[psychodynamic]] psychiatry,<ref name = "Revolution">{{cite journal | vauthors = Mayes R, Horwitz AV | title = DSM-III and the revolution in the classification of mental illness | journal = Journal of the History of the Behavioral Sciences | volume = 41 | issue = 3 | pages = 249–267 | year = 2005 | pmid = 15981242 | doi = 10.1002/jhbs.20103 }}</ref> although both manuals also included biological perspectives and concepts from [[Emil Kraepelin|Kraepelin]]'s system of classification. Symptoms were not specified in detail for specific disorders. Many were seen as reflections of broad underlying conflicts or maladaptive reactions to life problems that were rooted in a distinction between neurosis and [[psychosis]] (roughly, anxiety/depression broadly in touch with reality, as opposed to [[hallucinations]] or [[delusions]] disconnected from reality). Sociological and biological knowledge was incorporated, under a model that did not emphasize a clear boundary between normality and abnormality.<ref name="Transformation">{{cite journal | vauthors = Wilson M | title = DSM-III and the transformation of American psychiatry: a history | journal = The American Journal of Psychiatry | volume = 150 | issue = 3 | pages = 399–410 | date = March 1993 | pmid = 8434655 | doi = 10.1176/ajp.150.3.399 }}</ref> The idea that personality disorders did not involve emotional distress was discarded.<ref name=Oldham/>
A study published in ''Science'' in 1973, the [[Rosenhan experiment]], received much publicity and was viewed as an attack on the efficacy of psychiatric diagnosis.<ref name="Stuart A, Kirk & Herb Kutchins 1994">{{cite web |url=http://www.academyanalyticarts.org/kirk&kutchins.htm |title=The Myth of the Reliability of DSM | vauthors = Kirk SA, Kutchins H |year=1994 |work=Journal of Mind and Behavior, 15 (1&2) |archive-url=https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk%26kutchins.htm |archive-date=2008-03-07 }}</ref>
An influential 1974 paper by [[Robert Spitzer (psychiatrist)|Robert Spitzer]] and [[Joseph L. Fleiss]] demonstrated that the second edition of the DSM (DSM-II) was an unreliable diagnostic tool.<ref name=SpitzerFleiss1974>{{cite journal | vauthors = Spitzer RL, Fleiss JL | title = A re-analysis of the reliability of psychiatric diagnosis | journal = The British Journal of Psychiatry | volume = 125 | pages = 341–347 | date = October 1974 | issue = 587 | pmid = 4425771 | doi = 10.1192/bjp.125.4.341 | s2cid = 37782257 }}</ref> Spitzer and Fleiss found that different practitioners using the DSM-II rarely agreed when diagnosing patients with similar problems. In reviewing previous studies of eighteen major diagnostic categories, Spitzer and Fleiss concluded that "there are no diagnostic categories for which reliability is uniformly high. Reliability appears to be only satisfactory for three categories: mental deficiency, organic brain syndrome (but not its subtypes), and alcoholism. The level of reliability is no better than fair for psychosis and [[schizophrenia]] and is poor for the remaining categories".<ref name="Kirk & Kutchins">{{cite journal | vauthors = Kirk SA, Kutchins H |year=1994 |title=The Myth of the Reliability of DSM |journal=Journal of Mind and Behavior |volume=15 |issue=1&2 |pages=71–86 |url= http://www.academyanalyticarts.org/kirk&kutchins.htm |access-date=2008-03-04 |archive-url=https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk%26kutchins.htm |archive-date=2008-03-07 }}</ref>
====Seventh printing of the DSM-II (1974)====
As described by Ronald Bayer, a psychiatrist and gay rights activist, specific protests by [[gay rights]] activists against the APA began in 1970, when the organization held its convention in [[San Francisco]]. The activists disrupted the conference by interrupting speakers and shouting down and ridiculing psychiatrists who viewed homosexuality as a mental disorder. In 1971, gay rights activist [[Frank Kameny]] worked with the [[Gay Liberation Front]] collective to demonstrate at the APA's convention. At the 1971 conference, Kameny grabbed the microphone and yelled: "Psychiatry is the enemy incarnate. Psychiatry has waged a relentless war of extermination against us. You may take this as a declaration of war against you."<ref>Bayer, Ronald (1981). [https://archive.org/details/homosexualityame00bayerich ''Homosexuality and American Psychiatry: The Politics of Diagnosis''] Princeton University Press p. 105.</ref>
This gay activism occurred in the context of a broader [[anti-psychiatry]] movement that had come to the fore in the 1960s and was challenging the legitimacy of psychiatric diagnosis. Anti-psychiatry activists protested at the same APA conventions, with some shared slogans and intellectual foundations as gay activists.<ref>{{cite journal | vauthors = McCommon B | title = Antipsychiatry and the gay rights movement | journal = Psychiatric Services | volume = 57 | issue = 12 | pages = 1809; author reply 1809–1809; author reply 1810 | date = December 2006 | pmid = 17158503 | doi = 10.1176/appi.ps.57.12.1809 | s2cid = 37419476 | url = http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809 | archive-url = https://web.archive.org/web/20070810054520/http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809 | archive-date = 2007-08-10 }}</ref><ref>{{cite journal | vauthors = Rissmiller DJ, Rissmiller J | year = 2006 | title = Letter in reply | url = http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a | journal = Psychiatr Serv | volume = 57 | issue = 12| pages = 1809–1810 | doi = 10.1176/appi.ps.57.12.1809-a | archive-url = https://web.archive.org/web/20070630022511/http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a | archive-date = 2007-06-30 }}</ref>
Taking into account data from researchers such as [[Alfred Kinsey]] and [[Evelyn Hooker]], the seventh printing of the DSM-II, in 1974, no longer listed homosexuality as a category of disorder.{{efn|Determining the correct DSM-II printing where the change occurred can be confusing because the American Psychiatric Association publication that announced the change is titled, in part, "Proposed change in DSM-II, 6th printing, page 44". However, a notice in that publication indicates that "the change appears on page 44 of this, the seventh printing."}} After a vote by the APA trustees in 1973, and confirmed by the wider APA membership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance".<ref>{{cite journal | vauthors = Spitzer RL | title = The diagnostic status of homosexuality in DSM-III: a reformulation of the issues | journal = The American Journal of Psychiatry | volume = 138 | issue = 2 | pages = 210–215 | date = February 1981 | pmid = 7457641 | doi = 10.1176/ajp.138.2.210 }}</ref><ref>[https://pages.uoregon.edu/eherman/teaching/texts/DSM-II_Homosexuality_Revision.pdf Homosexuality and sexuality orientation disturbance: Proposed change in DSM-II, 6th printing, page 44. Position Statement (Retired)]. APA Document Reference No. 730008. Arlington, VA: American Psychiatric Association, 1973. ("Since the last printing of this Manual, the trustees of the American Psychiatric Association, in December 1973, voted to eliminate Homosexuality per se as a mental disorder and to substitute therefor a new category titled Sexual Orientation Disturbance. The change appears on page 44 of this, the seventh printing.").</ref>
===DSM-III (1980)===
The emergence of DSM III represented a "quantum leap" in terms of the scale and reach of the manual.<ref name="Coolidge and Segal 1998">{{cite journal |last1=Coolidge |first1=Frederick L. |last2=Segal |first2=Daniel L. |title=Evolution of personality disorder diagnosis in the Diagnostic and statistical manual of mental disorders |url=https://www.sciencedirect.com/science/article/abs/pii/S0272735898000026 |journal=Clinical Psychology Review |date=August 1998 |volume=18 |issue=5 |pages=585–599 |doi=10.1016/s0272-7358(98)00002-6 |pmid=9740979 |access-date=27 September 2023}}</ref> In 1974, the decision to revise the DSM was made, and psychiatrist [[Robert Spitzer (psychiatrist)|Robert Spitzer]] was selected as chair of the task force. The initial impetus was to make the DSM nomenclature consistent with that of the [[International Classification of Diseases]] (ICD). The revision took on a far wider mandate under the influence and control of Spitzer and his chosen committee members.<ref>{{cite magazine | vauthors = Spiegel A |url= http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact |title=The Dictionary of Disorder: How one man revolutionized psychiatry |date=3 January 2005 |magazine=The New Yorker |archive-url=https://web.archive.org/web/20061212180933/http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact |archive-date=12 December 2006 }}</ref> One added goal was to improve the uniformity and validity of psychiatric diagnosis in the wake of a number of critiques, including the famous [[Rosenhan experiment]]. There was also felt a need to standardize diagnostic practices within the United States and with other countries, after research showed that psychiatric diagnoses differed between Europe and the United States.<ref name="PMID5774702">{{cite journal | vauthors = Cooper JE, Kendell RE, Gurland BJ, Sartorius N, Farkas T | title = Cross-national study of diagnosis of the mental disorders: some results from the first comparative investigation | journal = The American Journal of Psychiatry | volume = 10 Suppl | issue = 10 Suppl | pages = 21–29 | date = April 1969 | pmid = 5774702 | doi = 10.1176/ajp.125.10s.21 | url = http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30 | archive-url = https://web.archive.org/web/20100824224731/http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30 | archive-date = 2010-08-24 }}</ref> The establishment of consistent criteria was an attempt to facilitate the pharmaceutical regulatory process.
The criteria adopted for many of the mental disorders were influenced by the [[Research Diagnostic Criteria]] (RDC) and [[Feighner Criteria]], which had just been developed by a group of research-orientated psychiatrists based primarily at [[Washington University School of Medicine]] and the [[New York State Psychiatric Institute]]. However, the influence of clinical psychiatrists, themselves often working with psychoanalytic ideas were still strong.<ref>{{cite book |last1=Decker |first1=Hannah S. |title=The making of DSM-III®: a diagnostic manual's conquest of American psychiatry |date=2013 |publisher=Oxford University Press |location=Oxford New York Auckland |isbn=9780195382235}}</ref> Other criteria, and potential new categories of disorder, were established by debate, argument and consensus during meetings of the committee chaired by Spitzer. A key aim was to base categorization on colloquial English (which would be easier to use by federal administrative offices), rather than by assumption of cause, although its categorical approach still assumed each particular pattern of symptoms in a category reflected a particular underlying pathology (an approach described as "[[Emil Kraepelin|neo-Kraepelinian]]"). The [[psychodynamic]] view was marginalised, although still influential, in favor of a [[regulatory]] or [[legislative]] model that emphasised observable symptoms.<ref name="Decker (2013)">{{cite book |last1=Decker |first1=Hannah S. |title=The making of DSM-III®: a diagnostic manual's conquest of American psychiatry |date=2013 |publisher=Oxford University Press |location=Oxford New York Auckland |isbn=9780195382235}}</ref> A new "multiaxial" system attempted to yield a picture more amenable to a statistical population census, rather than a simple [[medical diagnosis|diagnosis]]. Spitzer argued "mental disorders are a subset of medical disorders", but the task force decided on this statement for the DSM: "Each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome."<ref name="Revolution"/> [[Personality disorders]] were placed on axis II along with "mental retardation".<ref name=Oldham/>
The first draft of DSM-III was ready within a year. It introduced many new categories of disorder, while deleting or changing others. A number of unpublished documents discussing and justifying the changes have recently come to light.<ref>{{cite book| vauthors = Lane C | title = Shyness: How Normal Behavior Became a Sickness| year = 2007| publisher = Yale University Press| isbn = 978-0-300-12446-0| page = [https://archive.org/details/shynesshownormal00lane/page/263 263]| url-access = registration| url = https://archive.org/details/shynesshownormal00lane/page/263}}</ref> Field trials sponsored by the U.S. [[National Institute of Mental Health]] (NIMH) were conducted between 1977 and 1979 to test the reliability of the new diagnoses. A controversy emerged regarding deletion of the concept of neurosis, a mainstream of [[psychoanalytic]] theory and therapy but seen as vague and unscientific by the DSM task force. Faced with enormous political opposition, DSM-III was in serious danger of not being approved by the APA Board of Trustees unless "neurosis" was included in some form; a political compromise reinserted the term in parentheses after the word "disorder" in some cases. Additionally, the diagnosis of [[Ego-dystonic sexual orientation|ego-dystonic homosexuality]] replaced the DSM-II category of "sexual orientation disturbance". The [[Gender dysphoria in children|gender identity disorder in children]] (GIDC) diagnosis was introduced in the DSM-III; prior to the DSM-III's publication in 1980, there was no diagnostic criteria for [[gender dysphoria]].<ref>{{cite book | publisher = American Psychiatric Association | date = 1980 | title = Diagnostic and statistical manual of mental disorders | edition = 3rd | location = Washington, DC }}</ref><ref name="Need">{{Cite journal|last1=Butler|first1=Catherine|last2=Hutchinson|first2=Anna|year=2020|title=Debate: The pressing need for research and services for gender desisters/Detransitioners|journal=Child and Adolescent Mental Health|volume=25|issue=1|pages=45–47|doi=10.1111/camh.12361|pmid=32285632|s2cid=210484832|url=https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf |archive-url=https://web.archive.org/web/20221128201913/https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf |archive-date=2022-11-28 |url-status=live }}</ref>
Finally published in 1980, DSM-III listed 265 diagnostic categories and was 494 pages long. It rapidly came into widespread international use and has been termed a revolution, or transformation, in psychiatry.<ref name="Revolution"/><ref name="Transformation"/>
When DSM-III was published, the developers made extensive claims about the reliability of the radically new diagnostic system they had devised, which relied on data from special field trials. However, according to a 1994 article by [[Stuart A. Kirk]]:
{{blockquote|Twenty years after the reliability problem became the central focus of DSM-III, there is still not a single multi-site study showing that DSM (any version) is routinely used with high reliably by regular mental health clinicians. Nor is there any credible evidence that any version of the manual has greatly increased its reliability beyond the previous version. There are important methodological problems that limit the generalizability of most reliability studies. Each reliability study is constrained by the training and supervision of the interviewers, their motivation and commitment to diagnostic accuracy, their prior skill, the homogeneity of the clinical setting in regard to patient mix and base rates, and the methodological rigor achieved by the investigator ...<ref name="Stuart A, Kirk & Herb Kutchins 1994"/>}}
===DSM-III-R (1987)===
In 1987, DSM-III-R was published as a revision of the DSM-III, under the direction of Spitzer. Categories were renamed and reorganized, with significant changes in criteria. Six categories were deleted while others were added. Controversial diagnoses, such as [[Premenstrual dysphoric disorder|Premenstrual Dysphoric Disorder]] and [[Self-defeating personality disorder|Masochistic Personality Disorder]], were considered and discarded. (Premenstrual Dysphoric Disorder was later reincorporated in the DSM-5, published in 2013).<ref>American Psychological Association. (2013). ''Highlights of Changes from DSM-IV-TR to DSM-5'' [Fact sheet]. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf</ref> "Ego-dystonic homosexuality" was also removed and was largely subsumed under "sexual disorder not otherwise specified", which could include "persistent and marked distress about one's sexual orientation."<ref name="Revolution"/><ref>{{cite web | vauthors = Spiegel A, Glass I |date=18 January 2002 |url=http://www.thisamericanlife.org/radio-archives/episode/204/81-words |title=81 Words |website=This American Life |location=Chicago |publisher=WBEZ Chicago Public Radio }}</ref> Altogether, the DSM-III-R contained 292 diagnoses and was 567 pages long. Further efforts were made for the diagnoses to be purely descriptive, although the introductory text stated for at least some disorders, "particularly the Personality Disorders, the criteria require much more inference on the part of the observer"[page xxiii].<ref name=Oldham/>
===DSM-IV (1994)===
In 1994, DSM-IV was published, listing 410 disorders in 886 pages. The task force was chaired by [[Allen Frances]] and was overseen by a steering committee of twenty-seven people, including four psychologists. The steering committee created thirteen work groups of five to sixteen members, each work group having about twenty advisers in addition. The work groups conducted a three-step process: first, each group conducted an extensive literature review of their diagnoses; then, they requested data from researchers, conducting analyses to determine which criteria required change, with instructions to be conservative; finally, they conducted multi-center field trials relating diagnoses to clinical practice.<ref>{{cite book |vauthors=Frances A, Mack AH, Ross R, First MB |date=2000 |orig-date=1995 |chapter-url=http://www.acnp.org/G4/GN401000082/CH081.html |chapter=The DSM-IV Classification and Psychopharmacology |title=Psychopharmacology: The Fourth Generation of Progress |publisher=American College of Neuropsychopharmacology |veditors=Bloom FE, Kupfer DJ |access-date=2007-02-28 |archive-date=2007-03-23 |archive-url=https://web.archive.org/web/20070323150804/http://www.acnp.org/G4/GN401000082/CH081.html }}</ref><ref>{{cite journal | vauthors = Shaffer D | title = A participant's observations: preparing DSM-IV | journal = Canadian Journal of Psychiatry | volume = 41 | issue = 6 | pages = 325–329 | date = August 1996 | pmid = 8862851 | doi = 10.1177/070674379604100602 | s2cid = 28547523 }}</ref> A major change from previous versions was the inclusion of a clinical-significance criterion to almost half of all the categories, which required symptoms causing "clinically significant distress or impairment in social, occupational, or other important areas of functioning". Some personality-disorder diagnoses were deleted or moved to the appendix.<ref name=Oldham/>
==== DSM-IV Definitions ====
{{See also|DSM-IV codes}}
The DSM-IV characterizes a mental disorder as "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significant increased risk of suffering death, pain, disability, or an important loss of freedom".<ref>{{cite web | vauthors = Maisel ER | date = 23 July 2013 | title = The New Definition of a Mental Disorder | work = Psychology Today |url = https://www.psychologytoday.com/us/blog/rethinking-mental-health/201307/the-new-definition-mental-disorder }}</ref> It also notes that "although this manual provides a classification of mental disorders it must be admitted that no definition adequately specifies precise boundaries for the concept of 'mental disorder."<ref name="pmid20624327">{{cite journal | vauthors = Stein DJ, Phillips KA, Bolton D, Fulford KW, Sadler JZ, Kendler KS | title = What is a mental/psychiatric disorder? From DSM-IV to DSM-V | journal = Psychological Medicine | volume = 40 | issue = 11 | pages = 1759–1765 | date = November 2010 | pmid = 20624327 | pmc = 3101504 | doi = 10.1017/S0033291709992261 }}</ref>
==== DSM-IV Categorization ====
The DSM-IV is a categorical classification system. The categories are sigma, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<ref>{{cite journal | vauthors = Maser JD, Patterson T | title = Spectrum and nosology: implications for DSM-V | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = 855–885 | date = December 2002 | pmid = 12462864 | doi = 10.1016/s0193-953x(02)00022-9 }}</ref> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from [[tic disorder]]s and several of the [[paraphilia]]s due to their [[egosyntonic]] nature. Each category of disorder has a numeric code taken from the [[ICD coding system]], used for health service (including insurance) administrative purposes.
==== {{anchor|DSM-IV-TR multi-axial system}}DSM-IV multi-axial system ====
The DSM-IV was organized into a five-part axial system. Axis I provided information about clinical disorders, or any mental condition other than personality disorders and what was referred to in DSM editions prior to DSM-V as "mental retardation". Those were both covered on Axis II. Axis III covered medical conditions that could impact a person's disorder or treatment of a disorder and Axis IV covered psychosocial and environmental factors affecting the person. Axis V was the GAF, or global assessment of functioning, which was basically a numerical score between 0 and 100 that measured how much a person's psychological symptoms impacted their daily life.<ref>{{Cite book |url=https://www.ncbi.nlm.nih.gov/books/NBK519711/ |title=DSM-IV to DSM-5 Changes: Overview |publisher=Substance Abuse and Mental Health Services Administration |year=2016 |location=Internet |pages=DSM-5 Changes: Implications for Child Serious Emotional Disturbance}}</ref>
==== DSM-IV Sourcebooks ====
The DSM-IV does not specifically cite its sources, but there are four volumes of "sourcebooks" intended to be APA's documentation of the guideline development process and supporting evidence, including literature reviews, data analyses, and field trials.<ref>{{cite book|title=DSM-IV Sourcebook|date=1994|publisher=American Psychiatric Association|isbn=978-0-89042-065-2|volume=1|location=Washington, DC|url-access=registration|url=https://archive.org/details/dsmivsourcebook0000unse}}</ref><ref>{{cite book|title=DSM-IV Sourcebook|date=1996|publisher=American Psychiatric Association|isbn=978-0-89042-069-0|volume=2|location=Washington, DC|url-access=registration|url=https://archive.org/details/dsmivsourcebook0000unse}}</ref><ref>{{cite book|title=DSM-IV Sourcebook|date=1997|publisher=American Psychiatric Association|isbn=978-0-89042-073-7|volume=3|location=Washington, DC|url-access=registration|url=https://archive.org/details/dsmivsourcebook0000unse}}</ref><ref>{{cite journal|date=October 1999|title=DSM-IV Sourcebook, vol. 4 (Book Forum: Assessment and Diagnosis)|url=http://ajp.psychiatryonline.org/article.aspx?articleid=173760|journal=American Journal of Psychiatry|volume=156|issue=10|page=1655|doi=10.1176/ajp.156.10.1655| vauthors = Sadock BJ |access-date=2013-12-03|archive-url=https://web.archive.org/web/20131206233357/http://ajp.psychiatryonline.org/article.aspx?articleid=173760|archive-date=2013-12-06}}</ref> The sourcebooks have been said to provide important insights into the character and quality of the decisions that led to the production of DSM-IV, and the scientific credibility of contemporary psychiatric classification.<ref name="Poland01vol1">{{cite book | vauthors = Poland JS | date = 2001 | url = http://mentalhelp.net/books/books.php?type=de&id=557 | title = Review of Volume 1 of DSM-IV sourcebook | archive-url =https://web.archive.org/web/20050501182254/http://mentalhelp.net/books/books.php?type=de&id=557| archive-date = May 1, 2005}}</ref><ref name="Poland01vol2">{{cite book | vauthors = Poland JS | date = 2001 | url = http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74 | title = Review of vol 2 of DSM-IV sourcebook | archive-url = https://web.archive.org/web/20070927005022/http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74| archive-date= September 27, 2007}}</ref>
===DSM-IV-TR (2000)===
A text revision of DSM-IV, titled DSM-IV-TR, was published in 2000. The diagnostic categories were unchanged as were the diagnostic criteria for all but nine diagnoses.<ref>{{cite web | title = DSM-IV replaced by DSM-IV-TR: changes in diagnostic criteria | work = Behavenet |url=https://behavenet.com/dsm-iv-replaced-dsm-iv-tr-changes-diagnostic-criteria}}</ref> The majority of the text was unchanged; however, the text of two disorders, pervasive developmental disorder not otherwise specified and Asperger's disorder, had significant and/or multiple changes made. The definition of pervasive developmental disorder not otherwise specified was changed back to what it was in DSM-III-R and the text for Asperger's disorder was practically entirely rewritten. Most other changes were to the associated features sections of diagnoses that contained additional information such as lab findings, demographic information, prevalence, and course. Also, some diagnostic codes were changed to maintain consistency with ICD-9-CM.<ref name="pmid11875221">{{cite journal | vauthors = First MB, Pincus HA | title = The DSM-IV Text Revision: rationale and potential impact on clinical practice | journal = Psychiatric Services | volume = 53 | issue = 3 | pages = 288–292 | date = March 2002 | pmid = 11875221 | doi = 10.1176/appi.ps.53.3.288 }}</ref>
==DSM-5 (2013)==
{{Main|DSM-5}}
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5, was approved by the Board of Trustees of the APA on December 1, 2012.<ref>{{cite news | vauthors = Cassels C |date=2 December 2012 |url=http://www.medscape.com/viewarticle/775496 |title=DSM-5 Gets APA's Official Stamp of Approval |publisher=WebMD, LLC |website=Medscape |access-date=2012-12-05}}</ref> Published on May 18, 2013,<ref>{{cite web|title=Explainer: what is the DSM?|url=http://theconversation.com/explainer-what-is-the-dsm-14127|work=The Conversation Australia|publisher=The Conversation Media Group|access-date=2013-05-21| vauthors = Kinderman P |date=20 May 2013}}</ref> the DSM-5 contains extensively revised diagnoses and, in some cases, broadens diagnostic definitions while narrowing definitions in other cases.<ref>{{cite news|title=Books blast new version of psychiatry's bible, the DSM|url=https://www.usatoday.com/story/news/nation/2013/05/12/dsm-psychiatry-mental-disorders/2150819/|access-date=2013-05-21|newspaper=USA Today|date=12 May 2013| vauthors = Jayson S }}</ref> The DSM-5 is the first major edition of the manual in 20 years.<ref>{{cite news|title=DSM-5 Changes: What Parents Need To Know About The First Major Revision In Nearly 20 Years|url=http://www.huffingtonpost.com/2013/05/20/dsm5-changes-what-parents-need-to-know_n_3294413.html|access-date=2013-05-21|newspaper=The Huffington Post|date=20 May 2013| vauthors = Pearson C }}</ref> DSM-5, and the abbreviations for all previous editions, are [[Trademark#Registration|registered trademarks]] owned by the American Psychiatric Association.<ref name="concept&evolution" /><ref name="titleTrademark''' Electronic Search System (TESS)">{{cite web |title=Trademark Electronic Search System (TESS) |url=http://tess2.uspto.gov/ |access-date=2010-02-03}}</ref>
A significant change in the fifth edition is the deletion of the subtypes of [[schizophrenia]]: [[paranoid schizophrenia|paranoid]], [[disorganized schizophrenia|disorganized]], [[catatonic schizophrenia|catatonic]], [[undifferentiated schizophrenia|undifferentiated]], and [[residual schizophrenia|residual]].<ref>{{cite web|title=Highlights of Changes from DSM-IV-TR to DSM-5 |website=American Psychiatric Association |date=17 May 2013 |url=http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf |access-date=2015-01-04 |archive-url=https://web.archive.org/web/20150226050453/http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf |archive-date=2015-02-26 }}</ref> The deletion of the subsets of [[Autism spectrum|autistic spectrum disorder]]{{snd}}namely, [[Asperger's syndrome]], [[classic autism]], [[Rett syndrome]], [[childhood disintegrative disorder]] and [[pervasive developmental disorder not otherwise specified]]{{snd}}was also implemented, with specifiers regarding intensity: mild, moderate, and severe.
Severity is based on social communication impairments and restricted, repetitive patterns of behavior, with three levels:
# requiring support
# requiring substantial support
# requiring very substantial support
During the revision process, the APA website periodically listed several sections of the DSM-5 for review and discussion.<ref>{{Cite web|url=https://www.psychiatry.org/psychiatrists/practice/dsm|title=DSM-5|website=psychiatry.org|access-date=2019-08-29}}</ref>
===Future revisions and updates===
Beginning with the fifth edition, the APA communicated that they intend to add subsequent revisions more often, to keep up with research in the field.<ref>{{Cite web|url=https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions|title=DSM-5 FAQ|website=psychiatry.org|access-date=2019-08-29}}</ref> It is notable that DSM-5 uses [[Arabic numerals|Arabic]] rather than [[Roman numerals]]. Beginning with DSM-5, the APA will use decimals to identify incremental updates (e.g., DSM-5.1, DSM-5.2){{efn|However, this planned change was not adopted for the initial revision of the DSM-5, which is named DSM-5-TR, in accordance with past convention.}} and whole numbers for new editions (e.g., DSM-5, DSM-6),<ref>{{cite press release | vauthors = Harold E, Valora J |title=APA Modifies ''DSM'' Naming Convention to Reflect Publication Changes |location=Arlington, VA |publisher=American Psychiatric Association |date=9 March 2010 |url=http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx |format=PDF |archive-url=https://web.archive.org/web/20100613144808/http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx |archive-date=13 June 2010 |quote=Beginning with the upcoming fifth edition, new versions of the ''Diagnostic and Statistical Manual of Mental Disorders (DSM)'' will be identified with Arabic rather than Roman numerals, marking a change in how future updates will be created, ... Incremental updates will be identified with decimals, i.e. ''DSM-5.1'', ''DSM-5.2'', etc., until a new edition is required.}}</ref> similar to the scheme used for [[software versioning]].
The National Board of Medical Examiners (NBME), which is responsible for creating and publishing board exams for medical students around the United States, conforms to the use of DSM-5 criteria.<ref>{{Citation | title=Update: Exams to Transition to DSM-5 | journal=Psychiatric News| year=2014| volume=49| issue=22| page=1| doi=10.1176/appi.pn.2014.10a19| url=https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2014.10a19}}</ref>
=== DSM-5-TR (2022) ===
A revision of DSM-5, titled DSM-5-TR, was published in March 2022, updating diagnostic criteria and [[ICD-10-CM]] codes.<ref name=":3">{{Cite web |title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR™) |url=https://www.appi.org/products/dsm |website=American Psychiatric Association |access-date=April 18, 2022}}</ref> The diagnostic criteria for [[avoidant/restrictive food intake disorder]] was changed,<ref name=":5">{{Cite journal |last1=Appelbaum |first1=Paul S. |last2=Leibenluft |first2=Ellen |author-link2=Ellen Leibenluft |last3=Kendler |first3=Kenneth S. |date=2021-11-01 |title=Iterative Revision of the ''DSM'': An Interim Report From the ''DSM-5'' Steering Committee |journal=Psychiatric Services |volume=72 |issue=11 |pages=1348–1349 |doi=10.1176/appi.ps.202100013 |issn=1075-2730 |pmid=33882702 |s2cid=233349377}}</ref> along with adding entries for [[prolonged grief disorder]], [[Unspecified Mood Disorder|unspecified mood disorder]] and [[Stimulant-Induced Mild Neurocognitive Disorder|stimulant-induced mild neurocognitive disorder]].<ref name=":6">{{Cite journal |last1=First |first1=Michael B. |last2=Yousif |first2=Lamyaa H. |last3=Clarke |first3=Diana E. |last4=Wang |first4=Philip S. |last5=Gogtay |first5=Nitin |last6=Appelbaum |first6=Paul S. |date=2022-05-07 |title=DSM-5-TR: overview of what's new and what's changed |journal=World Psychiatry |volume=21 |issue=2 |pages=218–219 |doi=10.1002/wps.20989 |pmid=35524596 |pmc=9077590 |issn=1723-8617}}</ref><ref>{{Cite news |date=2022-09-08 |title=Prolonged grief disorder recognized as official diagnosis. Here's what to know about chronic mourning. |language=en-US |newspaper=[[The Washington Post]] |url=https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/ |access-date=2023-05-23 |issn=0190-8286}}</ref> Prolonged grief disorder, which had been present in the ICD-11, had criteria agreed upon by consensus in a one day in-person workshop sponsored by the APA.<ref name=":5" /> A 2022 study found that higher rates of diagnosis of prolonged grief disorder in the ICD-11 could be explained by the DSM-5-TR criteria requiring symptoms persist for 12 months, and the ICD-11 requiring only 6 months.<ref>{{Cite journal |date=2022 |title=Supplemental Material for Same Name, Same Content? Evaluation of DSM-5-TR and ICD-11 Prolonged Grief Criteria |journal=Journal of Consulting and Clinical Psychology |doi=10.1037/ccp0000720.supp |s2cid=248338204 |issn=0022-006X}}</ref>
Three review groups for sex and gender, culture and suicide, along with an "ethnoracial equity and inclusion work group" were involved in the creation of the DSM-5-TR which led to additional sections for each mental disorder discussing sex and gender, racial and cultural variations, and adding diagnostic codes for specifying levels of suicidality and nonsuicidal self-injury for mental disorders.<ref name=":6" /><ref name=":5" />
Other changed mental disorders included:<ref name=":4">{{Cite web |title=Updates to DSM-5 Criteria & Text |url=https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-criteria-text |access-date=April 18, 2022 |website=American Psychiatric Association}}</ref>
* [[Autism spectrum|Autism spectrum disorder]]
* [[Bipolar I disorder]], [[Bipolar II disorder]], and related [[bipolar disorder]]s
* [[Obsessive–compulsive personality disorder]] in the [[alternative DSM-5 model for personality disorders]]
* [[Major depressive episode|Depressive episodes]] with short-duration [[hypomania]]
* [[Intellectual disability|Intellectual developmental disorder]]
* [[Delusional disorder]]
* [[Disruptive mood dysregulation disorder]]
* [[Brief psychotic disorder]]
==DSM Library==
The APA have supplemented the DSM with supporting works, collectively forming the "DSM Library."<ref name=":7">{{Cite web |title=Psychiatry Online |url=https://dsm.psychiatryonline.org/ |access-date=2022-11-07 |website=DSM Library |language=en}}</ref> As of 2022, the other books in the library are "DSM-5 Handbook of Differential Diagnosis", "DSM-5 Clinical Cases", "DSM-5 Handbook on the Cultural Formulation Interview" and "Guía De Consulta De Los Criterios Diagnósticos Del DSM-5".<ref name=":7" />
==Criticisms==
Many criticisms have been leveled against the DSM and its usefulness as a diagnostic manual.
===Reliability and validity===
The revisions of the DSM from the 3rd Edition forward have been mainly concerned with [[Inter-rater reliability|diagnostic reliability]]{{snd}}the degree to which different diagnosticians agree on a diagnosis. Henrik Walter argued that psychiatry as a science can only advance if diagnosis is reliable. If clinicians and researchers frequently disagree about the diagnosis of a patient, then research into the causes and effective treatments of those disorders cannot advance. Hence, diagnostic reliability was a major concern of DSM-III. When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria. Neither the issue of reliability or validity was settled.<ref>{{cite web | vauthors = Ghaemi SN, Knoll IV JL, Pearlman T |date=14 October 2013 |title=Why DSM-III, IV, and 5 are Unscientific |website=Psychiatric Times: Couch in Crisis Blog |url=http://www.psychiatrictimes.com/blogs/couch-crisis/why-dsm-iii-iv-and-5-are-unscientific }}</ref><ref>{{cite journal | vauthors = Khoury B, Langer EJ, Pagnini F | title = The DSM: mindful science or mindless power? A critical review | journal = Frontiers in Psychology | volume = 5 | pages = 602 | date = 2014 | pmid = 24987385 | pmc = 4060802 | doi = 10.3389/fpsyg.2014.00602 | doi-access = free }}</ref>
In 2013, shortly before the publication of DSM-5, the director of the [[National Institute of Mental Health]] (NIMH), [[Thomas R. Insel]], declared that the agency would no longer fund research projects that relied exclusively on DSM diagnostic criteria, due to its lack of validity.<ref>{{cite web |vauthors=Insel T |date=29 April 2013 |title=Transforming Diagnosis |url=http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml |website=Director's Blog |publisher=National Institute of Mental Health |access-date=2013-09-02 |archive-date=2013-05-29 |archive-url=https://web.archive.org/web/20130529152509/http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml }}</ref> Insel questioned the validity of the DSM classification scheme because "diagnoses are based on a consensus about clusters of clinical symptoms" as opposed to "collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response."<ref>{{Cite web|url=https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml|title=NIMH » Transforming Diagnosis|website=nimh.nih.gov|language=en|access-date=2019-02-25|archive-date=2019-02-23|archive-url=https://web.archive.org/web/20190223235629/https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml}}</ref><ref>{{cite magazine| vauthors = Lane C |title=The NIMH Withdraws Support for DSM-5|url=http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5|magazine=Psychology Today}}</ref>
Field trials of DSM-5 brought the debate of reliability back into the limelight, as the diagnoses of some disorders showed poor reliability. For example, a diagnosis of [[major depressive disorder]], a common mental illness, had a poor reliability [[Cohen's kappa|kappa]] statistic of 0.28, indicating that clinicians frequently disagreed on diagnosing this disorder in the same patients. The most reliable diagnosis was major neurocognitive disorder, with a kappa of 0.78.<ref>{{cite journal | vauthors = Freedman R, Lewis DA, Michels R, Pine DS, Schultz SK, Tamminga CA, Gabbard GO, Gau SS, Javitt DC, Oquendo MA, Shrout PE, Vieta E, Yager J | display-authors = 6 | title = The initial field trials of DSM-5: new blooms and old thorns | journal = The American Journal of Psychiatry | volume = 170 | issue = 1 | pages = 1–5 | date = January 2013 | pmid = 23288382 | doi = 10.1176/appi.ajp.2012.12091189 | url = http://ajp.psychiatryonline.org/article.aspx?articleid=1555604 | archive-url = https://web.archive.org/web/20130115024502/http://ajp.psychiatryonline.org/article.aspx?articleID=1555604 | author-link8 = Susan Shur-Fen Gau | archive-date = 2013-01-15 }}</ref>
===Diagnosis based on superficial symptoms===
By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect these disorders based on statistical or clinical patterns. As such, it has been compared to a naturalist's field guide to birds, with similar advantages and disadvantages.<ref>{{cite journal | vauthors = McHugh PR | title = Striving for coherence: psychiatry's efforts over classification | journal = JAMA | volume = 293 | issue = 20 | pages = 2526–2528 | date = May 2005 | pmid = 15914753 | doi = 10.1001/jama.293.20.2526 }}</ref> The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. Proponents argue this absence of explanatory classification is necessary, but it presents a problem for researchers as it results in the grouping of individuals who may have little in common except superficial criteria.<ref name="concept&evolution" /><ref>Fadul. J. A. (2014) Diagnostic and Statistical Manual of Mental Disorders. In ''Encyclopedia of Theory & Practice in Psychopathology & Counseling.'' (p. 143). Raleigh, NC: Lulu Press.</ref> As [[DSM-III]] chief architect [[Robert Spitzer (psychiatrist)|Robert Spitzer]] and [[DSM-IV]] editor Michael First outlined in 2005, "little progress has been made toward understanding the [[pathophysiology|pathophysiological]] processes and cause of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."<ref>{{cite journal | vauthors = Davis JB | title = Classification of psychiatric disorders | journal = Canadian Medical Association Journal | volume = 122| issue = 7| date = April 1980 | page = 750 | pmid = 20313414 | pmc = 1801862| doi = }}</ref>
While there is generally a lack of consensus on underlying causation for most psychiatric disorders, some proponents of specific [[psychopathology|psychopathological]] paradigms have faulted the DSM for failing to incorporate evidence from other disciplines. For instance, [[evolutionary psychology]] distinguishes between genuine cognitive malfunctions and malfunctions due to psychological [[adaptations]] (that is learned behaviors may be adaptive in one context but maladaptive in another). However, this distinction is one that is challenged within general psychology.<ref>{{cite web | vauthors = Murphy D, Stich S |date=16 December 1998 |url=http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html |title=Darwin in the Madhouse: Evolutionary Psychology and the Classification of Mental Disorders |access-date=2013-12-03 |archive-url=https://web.archive.org/web/20131205122638/http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html |archive-date=5 December 2013 }}</ref><ref>{{cite journal | vauthors = Cosmides L, Tooby J | title = Toward an evolutionary taxonomy of treatable conditions | journal = Journal of Abnormal Psychology | volume = 108 | issue = 3 | pages = 453–464 | date = August 1999 | pmid = 10466269 | doi = 10.1037/0021-843x.108.3.453 }}</ref><ref>{{cite journal | vauthors = McNally RJ | title = On Wakefield's harmful dysfunction analysis of mental disorder | journal = Behaviour Research and Therapy | volume = 39 | issue = 3 | pages = 309–314 | date = March 2001 | pmid = 11227812 | doi = 10.1016/S0005-7967(00)00068-1 }}</ref>
There is also criticism of the strong [[Operationalization|operationalist]] viewpoint of the DSM. The DSM relies on [[operational definition]]s, which means that intuitive concepts like [[Depression (mood)|depression]] are defined by specific measurable criteria (observable behavior, specific timelines). Some have argued that instead of replacing metaphysical terms like "desire" or "purpose" the DSM chose to legitimize them by giving them operational definitions. However, this may have served only to provide a "reassurance fetish" for mainstream methodological practice, rather than representing a substantial and meaningful alteration of mainstream psychiatric practice.<ref>{{cite journal | vauthors = Hands DW |date=December 2004 |title=On Operationalisms and Economics |journal=Journal of Economic Issues |volume=38 |issue=4 |pages=953–968 |doi=10.1080/00213624.2004.11506751 |s2cid=141997867 }}</ref>
A central problem with the use of superficial symptoms is that psychiatry deals with the [[phenomenology (psychology)|phenomena]] of [[consciousness]], which adds much more complexity than the [[somatic symptom disorder|somatic]] [[symptom]]s and [[medical sign|signs]] used by most of medicine. A 2013 review published in the ''[[European Archives of Psychiatry and Clinical Neuroscience]]'' gives the example of the problem of superficial characterization of psychiatric signs and symptoms . If a patient says they "feel depressed, sad, or down" there are actually a wide variety of underlying experiences they could be referencing: "not only [[depression (mood)|depressed mood]] but also, for instance, [[irritability|irritation]], [[anger]], loss of meaning, varieties of [[fatigue (medical)|fatigue]], [[ambivalence]], [[rumination (psychology)|ruminations]] of different kinds, hyper-reflectivity, thought pressure, psychological [[anxiety]], varieties of [[depersonalization]], and even [[auditory hallucination|voices]] with negative content, and so forth." This criticism is especially pertinent to the [[structured interview]], as simple "yes or no" questions may not be specific enough to truly confirm or deny the [[diagnostic criteria|diagnostic criterion]] at issue. That is, whether a patient says yes or no will rely on their own understanding of the meaning of the various words in the question as well as their own interpretation of their experience. There is thus danger in being overconfident in the face value of the answers. The authors of the 2013 review give an example: A [[patient]] who was being administered the [[Structured Clinical Interview for DSM-IV|Structured Clinical Interview for the DSM-IV Axis I Disorders]] denied [[thought insertion]], but during a "conversational, [[phenomenology (psychology)|phenomenological]] interview", a [[semi-structured interview]] tailored to the patient, the same [[patient]] admitted to experiencing [[thought insertion]], along with a [[delusion|delusional elaboration]]. The authors suggested 2 reasons for this discrepancy: either the patient did not "recognize his own [[qualia|experience]] in the rather blunt, implicitly either/or formulation of the structured-interview question", or the [[qualia|experience]] did not "fully articulate itself" until the patient started talking about his experiences.<ref name = nordgaard1>{{cite journal | vauthors = Nordgaard J, Sass LA, Parnas J | title = The psychiatric interview: validity, structure, and subjectivity | journal = European Archives of Psychiatry and Clinical Neuroscience | volume = 263 | issue = 4 | pages = 353–364 | date = June 2013 | pmid = 23001456 | pmc = 3668119 | doi = 10.1007/s00406-012-0366-z | author-link2 = Louis Sass | author-link1 = Julie Nordgaard }}</ref>
===Obscuring root causes===
==== Economic causes ====
The DSM-5 has been criticized for overlooking [[capitalism]]’s interconnectivity with pathology.<ref>{{Cite journal |last=Olivier |first=B |date=2015 |title=Capitalism and suffering |url=http://ref.scielo.org/w7qdd5 |journal=Psychology in Society |volume=48 |pages=1–21 |doi=10.17159/2309-8708/2015/n48a1}}</ref> One example is the development and treatment of diagnoses: around 69% of psychiatrists involved in the development of the [[DSM-5]] were reported to have financial ties to the [[pharmaceutical industry]].<ref>{{Cite journal |last1=Cosgrove |first1=Lisa |last2=Wheeler |first2=Emily E |date=February 8, 2013 |title=Industry's colonization of psychiatry: Ethical and practical implications of financial conflicts of interest in the DSM-5 |url=http://journals.sagepub.com/doi/10.1177/0959353512467972 |journal=[[Feminism & Psychology]] |language=en |volume=23 |issue=1 |pages=93–106 |doi=10.1177/0959353512467972 |issn=0959-3535}}</ref> These ties situate many care services within the [[Medical–industrial complex|medical-industrial complex]], a framework that prioritizes profit instead of the care of individuals.<ref>{{Cite book |last=Magee |first=Mike |title=Code blue: inside America's medical industrial complex |publisher=[[Atlantic Monthly Press]] |year=2019 |isbn=978-0-8021-4687-8 |edition=1st |location=New York}}</ref> Lane found the [[Medical–industrial complex|medical-industrial complex]] intertwined with setting the parameters to diagnose conditions such as [[social anxiety disorder]].<ref>{{Cite book |last=Lane |first=Christopher |title=Shyness: how normal behavior became a sickness |date=2007 |publisher=Yale University Press |isbn=978-0-300-14317-1 |location=New Haven}}</ref> Other authors have supported similar findings.<ref>{{Cite book |last=Tone |first=Andrea |title=The Age of Anxiety: A History of America's Turbulent Affairs with Tranquilizers |date=January 3, 2012 |publisher=[[Basic Books]] |isbn=978-0465025206 |edition=1st |location=New York}}</ref><ref>{{Cite journal |last=Timler |first=Kelsey |date=2022 |title=Distorted Thinking or Distorted Realities? The Social Construction of Anxiety for Women in Neoliberal Late-Stage Capitalism |url=https://www.cambridge.org/core/product/identifier/S0887536722000605/type/journal_article |journal=Hypatia |language=en |volume=37 |issue=4 |pages=726–742 |doi=10.1017/hyp.2022.60 |issn=0887-5367}}</ref> Kincaid and Sullivan estimate that the cost of the industry surrounding diagnosis will rise to around six trillion dollars by 2030.<ref>{{Cite book |url=https://direct.mit.edu/books/book/3043/Classifying-PsychopathologyMental-Kinds-and |title=Classifying Psychopathology: Mental Kinds and Natural Kinds |date=2014-04-04 |publisher=The MIT Press |isbn=978-0-262-32243-0 |editor-last=Kincaid |editor-first=Harold |language=en |doi=10.7551/mitpress/8942.001.0001 |editor-last2=Sullivan |editor-first2=Jacqueline A.}}</ref>
Scholars differ in the extent of [[capitalism]]'s influence on diagnosis. Davies supports the [[social model of disability]] in explaining that diagnosis at present relies on considering conditions a consequence of a “broken brain.”<ref name=":10">{{Cite book |last=Davies |first=James |title=Sedated: How Modern Capitalism Created our Mental Health Crisis |date=March 3, 2022 |publisher=[[Atlantic Books]] |isbn=978-1786499875 |edition=1st |location=London}}</ref> His wider logic on mental illness in response to societal issues problematizes diagnosis as a tool of the [[Medical–industrial complex#:~:text=December 2022),and services for a profit.|medical-industrial complex]].<ref name=":10" /> His previous book, ''Cracked'', demonstrates the market interactions within the [[Medical–industrial complex#:~:text=December 2022),and services for a profit.|medical-industrial complex]], as diagnosis becomes a source for monetization.<ref>{{Cite book |last=Davies |first=James |title=Cracked: why psychiatry is doing more harm than good |date=2014 |publisher=[[Icon Books|Icon]] |isbn=978-1-84831-654-6 |location=London}}</ref>
Others find that the dependency of patients on their psychiatric care providers makes the industry vulnerable to economic exploitation under [[capitalism]].<ref name=":11">{{Cite journal |last=U'Ren |first=Richard |date=1997 |title=Psychiatry and Capitalism |url=https://www.jstor.org/stable/43853806 |journal=The Journal of Mind and Behavior |volume=18 |issue=1 |pages=1–11 |jstor=43853806 |issn=0271-0137}}</ref> These individuals argue that diagnosis is manipulated, but not caused, by capitalistic forces.<ref name=":11" /> Academics have critiqued the directness of the association between the [[medical model]], [[capitalism]], and diagnosis, but generally agree that characteristics of the capitalist system contribute to poor [[mental health]].<ref>{{Cite journal |last=Barney |first=Ken |date=1994 |title=Limitations of the Critique of the Medical Model |url=https://www.jstor.org/stable/43853630 |journal=The Journal of Mind and Behavior |volume=15 |issue=1/2 |pages=19–34 |jstor=43853630 |issn=0271-0137}}</ref>
==== Institutional causes ====
Diagnoses of mental conditions have been used to obscure institutional practices of [[discrimination]].<ref>{{Cite journal |last1=Lebowitz |first1=Matthew S. |last2=Ahn |first2=Woo-kyoung |date=2014-12-16 |title=Effects of biological explanations for mental disorders on clinicians' empathy |journal=Proceedings of the National Academy of Sciences |language=en |volume=111 |issue=50 |pages=17786–17790 |doi=10.1073/pnas.1414058111 |doi-access=free |issn=0027-8424 |pmc=4273344 |pmid=25453068|bibcode=2014PNAS..11117786L }}</ref> Late nineteenth-century diagnoses of white women with [[hysteria]], for instance, were said to be caused by “overcivilization,” shaped by racially discriminatory [[Social Darwinism]].<ref>{{Cite journal |last=Briggs |first=Laura |date=June 2000 |title=The Race of Hysteria: "Overcivilization" and the "Savage" Woman in Late Nineteenth-Century Obstetrics and Gynecology |url=https://muse.jhu.edu/article/2437 |journal=American Quarterly |language=en |volume=52 |issue=2 |pages=246–273 |doi=10.1353/aq.2000.0013 |pmid=16858900 |issn=1080-6490}}</ref> Similarly, American physician [[Samuel A. Cartwright|Samuel Cartwright]] coined "[[drapetomania]]" in 1851 as a mental condition which "caused" slaves to escape captivity.<ref>{{Cite book |last=Hogarth |first=Rana A. |title=Medicalizing blackness: making racial difference in the Atlantic world, 1780-1840 |date=2017 |publisher=The University of North Carolina Press |isbn=978-1-4696-3286-5 |location=Chapel Hill}}</ref> In the present day, Brinkmann finds that “contemporary diagnostic cultures,” whereby humans assess their conditions through a psychiatric lens, can “risk losing sight of the larger historical and social forces that affect [their] lives.”<ref name=":12">{{Cite book |last=Brinkmann |first=Svend |title=Diagnostic cultures: a cultural approach to the pathologization of modern life |date=2016 |publisher=Routledge, Taylor Francis Group |isbn=978-1-4724-1319-2 |series=Classical and contemporary social theory |location=London ; New York}}</ref> Contemporary diagnostic cultures help explain how diagnosis reflect larger historical biases.<ref name=":12" /><ref name=":13">{{Cite book |last=Metzl |first=Jonathan Michel |title=The protest psychosis: how schizophrenia became a black disease |date=2011 |publisher=Beacon |isbn=978-0-8070-0127-1 |location=Boston, Mass}}</ref>
Critics have argued that the DSM-5's criteria pathologize a wide range of people with distress or impairment. Chapman et al. discuss the implications for obscuring distress in the [[Imprisonment|incarceration and confinement]] of "intellectually disabled" populations; they argue that "differentiation based on [[Intellectual disability|psychiatric and intellectual disability]]" is arbitrarily set and altered based on [[capitalism]]'s needs for "mobile and free workers."<ref>{{Cite book |title=Disability incarcerated: imprisonment and disability in the United States and Canada |date=2014 |publisher=Palgrave Macmillan |isbn=978-1-137-39323-4 |editor-last=Ben-Moshe |editor-first=Liat |location=New York, NY |editor-last2=Carey |editor-first2=Allison C.}}</ref> Metzl demonstrates that the shifting diagnostic parameters of [[schizophrenia]] became a method for institutionalizing Black men during the [[Civil rights movement|Civil Rights Movement]].<ref name=":13" /> In sum, those who have experienced “domination” or “exploitation” based on an identity trait are more likely to be pathologized through diagnosis.<ref>{{Cite journal |last1=Prins |first1=Seth J. |last2=Bates |first2=Lisa M. |last3=Keyes |first3=Katherine M. |last4=Muntaner |first4=Carles |date=November 1, 2015 |title=Anxious? Depressed? You might be suffering from capitalism: contradictory class locations and the prevalence of depression and anxiety in the USA |journal=Sociology of Health & Illness |language=en |volume=37 |issue=8 |pages=1352–1372 |doi=10.1111/1467-9566.12315 |issn=0141-9889 |pmc=4609238 |pmid=26385581}}</ref>
===Overdiagnosis===
[[Allen Frances]], an outspoken critic of DSM-5, states that "normality is an endangered species," because of "fad diagnoses" and an "epidemic" of over-diagnosing, and suggests that the "DSM-5 threatens to provoke several more [epidemics]."<ref>{{Cite news|url=https://psychcentral.com/blog/overdiagnosis-mental-disorders-and-the-dsm-5/|title=Overdiagnosis, Mental Disorders and the DSM-5|date=2010-07-26|work=World of Psychology|access-date=2018-09-18|language=en-US}}</ref><ref>{{Cite web|url=https://www.psychologytoday.com/us/blog/dsm5-in-distress/201006/psychiatric-fads-and-overdiagnosis|title=Psychiatric Fads and Overdiagnosis|website=Psychology Today|language=en-US|access-date=2018-09-18}}</ref> Some researchers state that changes in diagnostic criteria, following each published version of the DSM, reduce thresholds for a diagnosis, which results in increases in prevalence rates for ADHD and [[Autism spectrum|autism spectrum disorder]].<ref>{{cite journal | vauthors = Thomas R, Mitchell GK, Batstra L | title = Attention-deficit/hyperactivity disorder: are we helping or harming? | journal = BMJ | volume = 347 | issue = nov05 1 | pages = f6172 | date = November 2013 | pmid = 24192646 | doi = 10.1136/bmj.f6172 | s2cid = 32080132 | url = http://www.bmj.com/cgi/content/short/348/jul01_1/g4377 }}</ref><ref name="bruchmuller 2012">{{cite journal | vauthors = Bruchmüller K, Margraf J, Schneider S | title = Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis | journal = Journal of Consulting and Clinical Psychology | volume = 80 | issue = 1 | pages = 128–138 | date = February 2012 | pmid = 22201328 | doi = 10.1037/a0026582 | s2cid = 6436414 }}</ref><ref>{{cite journal | vauthors = Vande Voort JL, He JP, Jameson ND, Merikangas KR | title = Impact of the DSM-5 attention-deficit/hyperactivity disorder age-of-onset criterion in the US adolescent population | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 53 | issue = 7 | pages = 736–744 | date = July 2014 | pmid = 24954823 | doi = 10.1016/j.jaac.2014.03.005 }}</ref><ref>{{cite journal | vauthors = Wing L, Potter D | title = The epidemiology of autistic spectrum disorders: is the prevalence rising? | journal = Mental Retardation and Developmental Disabilities Research Reviews | volume = 8 | issue = 3 | pages = 151–161 | date = 2002 | pmid = 12216059 | doi = 10.1002/mrdd.10029 }}</ref> Bruchmüller, et al. (2012) suggest that as a factor that may lead to overdiagnosis are situations when the clinical judgment of the diagnostician regarding a diagnosis (ADHD) is affected by [[heuristic]]s.<ref name="bruchmuller 2012"/>
===Dividing lines===
Despite caveats in the introduction to the DSM, it has long been argued that its [[Classification of mental disorders|system of classification]] makes unjustified categorical distinctions between disorders and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM [[syndromes]], or between a common DSM syndrome and normality, have failed.<ref name="concept&evolution"/> Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.<ref>{{cite web | vauthors = Spitzer RL, Williams JB, First MB, Gibbon M |title=Biometric Research |website= Psychiatric Institute 2001-2002 |publisher=New York State Psychiatric Institute |url=http://nyspi.org/AR2001/Biometrics.htm |archive-url=https://web.archive.org/web/20030307205740/http://nyspi.org/AR2001/Biometrics.htm |archive-date=7 March 2003 }}</ref><ref>{{cite journal | vauthors = Maser JD, Akiskal HS | title = Spectrum concepts in major mental disorders | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = xi–xiii | date = December 2002 | pmid = 12462854 | doi = 10.1016/S0193-953X(02)00034-5 }}</ref><ref>{{cite journal | vauthors = Krueger RF, Watson D, Barlow DH | title = Introduction to the special section: toward a dimensionally based taxonomy of psychopathology | journal = Journal of Abnormal Psychology | volume = 114 | issue = 4 | pages = 491–493 | date = November 2005 | pmid = 16351372 | pmc = 2242426 | doi = 10.1037/0021-843X.114.4.491 }}</ref>
In addition, it is argued that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.<ref>{{cite journal | vauthors = Wakefield JC, Schmitz MF, First MB, Horwitz AV | title = Extending the bereavement exclusion for major depression to other losses: evidence from the National Comorbidity Survey | journal = Archives of General Psychiatry | volume = 64 | issue = 4 | pages = 433–440 | date = April 2007 | pmid = 17404120 | doi = 10.1001/archpsyc.64.4.433 | doi-access = }}</ref> The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.
Because an individual's degree of impairment is often not correlated with symptom counts and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.<ref>{{cite journal | vauthors = Spitzer RL, Wakefield JC | title = DSM-IV diagnostic criterion for clinical significance: does it help solve the false positives problem? | journal = The American Journal of Psychiatry | volume = 156 | issue = 12 | pages = 1856–1864 | date = December 1999 | pmid = 10588397 | doi = 10.1176/ajp.156.12.1856 | s2cid = 25642814 }}</ref> On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life.
===Cultural bias===
Psychiatrists have argued that published diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.<ref name=Widiger2000/> Advocating a more [[culturally sensitive]] approach to psychology, critics such as [[Carl Bell (physician)|Carl Bell]] and Marcello Maviglia contend that researchers and service-providers often discount the cultural and ethnic diversity of individuals.<ref name="wash-post">{{cite news | vauthors = Vedantam S |date= June 26, 2005 |title = Psychiatry's Missing Diagnosis: Patients' Diversity Is Often Discounted |url= https://www.washingtonpost.com/wp-dyn/content/article/2005/06/25/AR2005062500982.html |newspaper= [[The Washington Post]] }}</ref> In addition, current diagnostic guidelines have been criticized<ref>{{cite journal | vauthors = Sashidharan SP, Francis E | title = Racism in psychiatry necessitates reappraisal of general procedures and Eurocentric theories | journal = BMJ | volume = 319 | issue = 7204 | pages = 254 | date = July 1999 | pmid = 10417096 | pmc = 1116337 | doi = 10.1136/bmj.319.7204.254 }}</ref> as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criterion-set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.<ref name="Widiger2000">{{cite journal | vauthors = Widiger TA, Sankis LM | title = Adult psychopathology: issues and controversies | journal = Annual Review of Psychology | volume = 51 | issue = 1 | pages = 377–404 | year = 2000 | pmid = 10751976 | doi = 10.1146/annurev.psych.51.1.377 }}</ref> [[Cross-cultural psychiatry|Cross-cultural]] psychiatrist [[Arthur Kleinman]] contends that Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.<ref>{{cite journal | vauthors = Kleinman A | title = Triumph or pyrrhic victory? The inclusion of culture in DSM-IV | journal = Harvard Review of Psychiatry | volume = 4 | issue = 6 | pages = 343–344 | year = 1997 | pmid = 9385013 | doi = 10.3109/10673229709030563 | s2cid = 43256486 }}</ref> Other cross-cultural critics largely share Kleinman's negative view toward the [[culture-bound syndrome]], common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.<ref>Bhugra, D. & Munro, A. (1997) ''Troublesome Disguises: Underdiagnosed Psychiatric Syndromes'' Blackwell Science Ltd {{ISBN missing|date=August 2016}}</ref>{{Page needed|date= August 2016}}
Mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.<ref name="Widiger2000" /> One result of this dissatisfaction was the development of the Azibo Nosology by Daudi Ajani Ya Azibo as an alternative to the DSM in treating patients of the [[African diaspora]].<ref>{{cite journal | vauthors = Irene A, Azibo DA | year = 1991 | title = Diagnosing personality disorder in Africans (Blacks) using the Azibo nosology: Two case studies | journal = Journal of Black Psychology | volume = 17 | issue = 2| pages = 1–22 | doi= 10.1177/00957984910172002|s2cid= 144458287 }}</ref><ref>{{cite journal | vauthors= ya Azibo DA |date= November 2014 |title= The Azibo Nosology II: Epexegesis and 25th Anniversary Update: 55 Culture-focused Mental Disorders Suffered by African Descent People |journal= Journal of Pan African Studies |volume= 7 |issue= 5 |pages= 32–176 |url= http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf |archive-url=https://web.archive.org/web/20151121133043/http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf |archive-date=2015-11-21 |url-status=live }}</ref><ref>{{cite journal | vauthors = Zulu IM |title= The Azibo Nosology: An Interview with Daudi Ajani ya Azibo |journal= Journal of Pan African Studies |volume= 7 |issue =5 |pages= 209–214 |url= http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf |archive-url=https://web.archive.org/web/20160820114756/http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf |archive-date=2016-08-20 |url-status=live }}</ref>
Historically, the DSM tended to avoid issues involving [[religion]]; the DSM-5 relaxed this attitude somewhat.<ref>
{{cite journal | vauthors = Chandler E | title = Religious and spiritual issues in DSM-5: matters of the mind and searching of the soul | journal = Issues in Mental Health Nursing | volume = 33 | issue = 9 | pages = 577–582 | date = September 2012 | pmid = 22957950 | doi = 10.3109/01612840.2012.704130 | quote = Given the important role that spirituality and religion play for many people in the experiences of coping with health and illness, it seems odd that such important elements are in the margins of the powerful and commanding nosology of the DSM. Explanations for understanding the glaring absence are complex and impacted by some very powerful political and sociological forces, including contributory elements from within the mental health disciplines. This article invites the reader to explore salient issues in the emergence of a broader recognition of religion, spirituality and psychiatric diagnosis in the DSM-5. | s2cid = 3453154 }}
</ref>
===Medicalization and financial conflicts of interest===
There was extensive analysis and comment on DSM-IV (published in 1994) in the years leading up to the 2013 publication of DSM-5. It was alleged that the way the categories of DSM-IV were structured, as well as the substantial expansion of the number of categories within it, represented increasing [[medicalization]] of human nature, very possibly attributable to [[disease mongering]] by psychiatrists and [[pharmaceutical companies]], the power and influence of the latter having grown dramatically in recent decades.<ref>Healy D (2006) [http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1 The Latest Mania: Selling Bipolar Disorder] {{webarchive|url=https://web.archive.org/web/20090212110644/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0030185&ct=1 |date=2009-02-12 }} PLoS Med 3(4): e185.</ref> In 2005, then APA President [[Steven Sharfstein]] released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".<ref>{{cite journal | vauthors = Cosgrove L, Krimsky S, Vijayaraghavan M, Schneider L | title = Financial ties between DSM-IV panel members and the pharmaceutical industry | journal = Psychotherapy and Psychosomatics | volume = 75 | issue = 3 | pages = 154–160 | date = 2006 | pmid = 16636630 | doi = 10.1159/000091772 | s2cid = 11909535 }}</ref> It was reported that of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had financial relationships with the pharmaceutical industry during the period 1989–2004, raising the prospect of a direct [[Conflict of interest#Relationship to medical research|conflict of interest]]. The same article concluded that the connections between panel members and the drug companies were particularly strong involving those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.
[[William Glasser]] referred to DSM-IV as having "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".<ref>{{cite web |url=http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html |title=(Susan Bowman, 2006) |publisher=The National Psychologist |date=2006-11-01 |access-date=2013-12-03 |archive-date=2017-06-26 |archive-url=https://web.archive.org/web/20170626220701/http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html }}</ref> A 2012 article in ''[[The New York Times]]'' commented sharply that DSM-IV (then in its 18th year), through copyrights held closely by the APA, had earned the Association over $100 million.<ref name="Greenberg">
{{cite news | url= https://www.nytimes.com/2012/01/30/opinion/the-dsms-troubled-revision.html | work= The New York Times | vauthors = Greenberg G | title = The D.S.M.'s Troubled Revision | date = January 29, 2012}} The article's closing words: "it [the APA] will be laughing all the way to the bank."</ref>
However, although the number of identified diagnoses had increased by more than 300% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argued that this almost entirely represented greater specification of the forms of pathology, thereby allowing better grouping of similar patients.<ref name="concept&evolution"/>
===Potential harm of labels===
A core function of the DSM is the categorization of people's experiences into diagnoses based on symptoms. However, there is disagreement about the use of diagnoses as labels. Some individuals are relieved to find they have a recognized condition that they can apply a name to, and this has led to many people [[Self-diagnosis|self-diagnosing]].<ref>{{Cite journal | vauthors = Giles DC, Newbold J |date= March 2011 |title=Self- and Other-Diagnosis in User-Led Mental Health Online Communities |url=http://journals.sagepub.com/doi/10.1177/1049732310381388 |journal=Qualitative Health Research |language=en |volume=21 |issue=3 |pages=419–428 |doi=10.1177/1049732310381388 |pmid= 20739589 |s2cid= 1853974 |issn=1049-7323}}</ref> Others, however, question the accuracy of diagnosis, or feel they have been given a label that invites [[social stigma]] and [[discrimination]] (the terms "[[mentalism (discrimination)|mentalism]]" and "sanism" have been used to describe such discriminatory treatment).<ref name="Sane">[http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf Sanism in Theory and Practice] {{Webarchive|url=https://web.archive.org/web/20140317045503/http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf |date=2014-03-17 }} May 9/10, 2011. Richard Ingram, Centre for the Study of Gender, Social Inequities and Mental Health. [[Simon Fraser University]], Canada</ref>
Diagnoses can become [[Internalization (psychology)|internalized]] and affect an individual's [[self-identity]], and some psychotherapists have found that the healing process can be inhibited and symptoms can worsen as a result.<ref>[http://jhp.sagepub.com/cgi/content/abstract/41/4/36 "How Using the Dsm Causes Damage: A Client's Report"] ''Journal of Humanistic Psychology'', Vol. 41, No. 4, 36–56 (2001)</ref> Some members of the [[psychiatric survivors movement]] (more broadly the consumer/survivor/ex-patient movement) actively campaign against their diagnoses, or the assumed implications, or against the DSM system in general.<ref name="CapeTown">{{cite web
| url=https://madpridect.wordpress.com/2013/06/08/known-as-the-psychiatric-bible-the-diagnostic-and-statistical-manual-of-mental-disorders-appears-in-a-fifth-edition/
| title=Known as the 'psychiatric bible', the Diagnostic and Statistical Manual of Mental Disorders appears in a fifth edition
| author=Cape Town Mad Pride
| author-link=Mad Pride
| access-date=28 Feb 2019
| date=2013-06-08
}}</ref><ref name="Medscape">
Michael T. Compton (2007) [http://www.medscape.com/viewarticle/565489_print Recovery: Patients, Families, Communities] Conference Report, Medscape Psychiatry & Mental Health, October 11–14, 2007
</ref> Additionally, it has been noted that the DSM often uses definitions and terminology that are inconsistent with a [[recovery model]], and such content can erroneously imply excess psychopathology (e.g. multiple "[[comorbid]]" diagnoses) or [[Chronic (medicine)|chronicity]].<ref name="Medscape"/>
===Critiques of DSM-5===
Psychiatrist [[Allen Frances]] has been critical of proposed revisions to the DSM–5. In a 2012 ''New York Times'' editorial, Frances warned that if this DSM version is issued unamended by the APA, "it will medicalize normality and result in a glut of unnecessary and harmful drug prescription."<ref name="nyt">{{cite news | vauthors = Frances A |date=11 May 2012 |url=https://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html |title=Diagnosing the D.S.M. |newspaper=New York Times |edition=New York |page=A19 }}</ref>
In a December 2012, blog post on ''[[Psychology Today]]'', Frances provides his "list of DSM 5's ten most potentially harmful changes:"<ref name="dsm5GuideNotBible">{{cite web| vauthors = Frances AJ |title=DSM 5 Is Guide Not Bible{{snd}}Ignore Its Ten Worst Changes: APA approval of DSM-5 is a sad day for psychiatry|url=http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes|access-date=2013-03-09|website=Psychology Today|date=December 2, 2012}}</ref>
* Disruptive Mood Dysregulation Disorder, for temper tantrums
* Major Depressive Disorder, includes normal grief
* Minor Neurocognitive Disorder, for normal forgetfulness in old age
* Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants
* Binge Eating Disorder, for excessive eating
* Autism, defining the disorder more specifically, possibly leading to decreased rates of diagnosis and the disruption of school services
* First-time drug users will be lumped in with addicts
* Behavioral Addictions, making a "mental disorder of everything we like to do a lot."
* Generalized Anxiety Disorder, includes everyday worries
* Post-traumatic stress disorder, changes "opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."<ref name="dsm5GuideNotBible" />
A group of 25 psychiatrists and researchers, among whom were Frances and [[Thomas Szasz]], have published debates on what they see as the six most essential questions in psychiatric diagnosis:<ref name="Phillips">{{cite journal | vauthors = Phillips J, Frances A, Cerullo MA, Chardavoyne J, Decker HS, First MB, Ghaemi N, Greenberg G, Hinderliter AC, Kinghorn WA, LoBello SG, Martin EB, Mishara AL, Paris J, Pierre JM, Pies RW, Pincus HA, Porter D, Pouncey C, Schwartz MA, Szasz T, Wakefield JC, Waterman GS, Whooley O, Zachar P | display-authors = 6 | title = The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis | journal = Philosophy, Ethics, and Humanities in Medicine | volume = 7 | issue = 1 | pages = 3 | date = January 2012 | pmid = 22243994 | pmc = 3305603 | doi = 10.1186/1747-5341-7-3 | doi-access = free }}</ref>
* Are they more like theoretical constructs or more like diseases?
* How to reach an agreed definition?
* Should the DSM-5 take a cautious or conservative approach?
* What is the role of practical rather than scientific considerations?
* How should it be used by clinicians or researchers?
* Is an entirely different diagnostic system required?
In 2011, psychologist [[Brent Robbins]] co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Over 15,000 individuals and [[mental health]] professionals have signed a petition in support of the letter.<ref name = "pointpark"/> Thirteen other APA divisions have endorsed the petition.<ref name = pointpark>{{cite web |url=http://www.pointpark.edu/NewsArtsSciences.aspx?id=467 |title=Professor co-authors letter about America's mental health manual |date=December 12, 2011 |work=Point Park University |access-date=2012-04-04 |archive-url=https://web.archive.org/web/20120329184708/http://www.pointpark.edu/NewsArtsSciences.aspx?id=467 |archive-date=2012-03-29 }}</ref> Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.<ref>{{cite news |url=http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/26/MNJJ1M3DFK.DTL |title=Revision of psychiatric manual under fire| vauthors = Allday E |date=November 26, 2011 |work=San Francisco Chronicle }}</ref>
== See also ==
{{col div|colwidth=30em}}
* [[Chinese Classification and Diagnostic Criteria of Mental Disorders]]
* [[Classification of mental disorders]]
* [[Diagnostic classification and rating scales used in psychiatry]]
* [[DSM-IV Codes]]
* [[Global Assessment of Functioning|Global Assessment of Functioning (GAF) Scale]]
* [[International Statistical Classification of Diseases and Related Health Problems|International Statistical Classification of Diseases and Related Health Problems (ICD)]]
* [[Kraepelinian dichotomy]]
* [[Psychodynamic Diagnostic Manual]]
* [[Relational disorder]] (proposed DSM-5 new diagnosis)
* [[Research Domain Criteria]] (RDoC), a framework being developed by the National Institute of Mental Health
* [[Rosenhan experiment]]
* [[Structured Clinical Interview for DSM-IV]] ''(SCID)''
* [[Homosexuality in DSM]]
{{colend}}
== Notes ==
{{Notelist}}
== References ==
{{Reflist|30em}}
== Further reading ==
{{refbegin}}
* {{cite book| author = American Psychiatric Association| title = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®| url = https://books.google.com/books?id=3SQrtpnHb9MC| year = 2000| publisher = American Psychiatric Pub| isbn = 978-0-89042-025-6 }}
* {{cite book| vauthors = Spitzer RL | title = Dsm-Iv-Tr Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders| url = https://books.google.com/books?id=S_xe-AX4UjMC| year = 2002| publisher = American Psychiatric Pub| isbn = 978-1-58562-059-3 }}
{{refend}}
== External links ==
* [http://www.dsm5.org/pages/default.aspx Official DSM-5 development website]
* [http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm Diagnostic Criteria from DSM-IV-TR]{{dead link|date=December 2021|bot=medic}}{{cbignore|bot=medic}}
* [https://archive.today/20120527015056/http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm Diagnostic Criteria from DSM-IV-TR]
* [https://apicalhealth.com/illness-and-recovery/dsm-iv/ The Multiaxial System of Diagnosis in DSM-IV Criteria] {{Webarchive|url=https://web.archive.org/web/20210116142849/https://apicalhealth.com/illness-and-recovery/dsm-iv/ |date=2021-01-16 }}
{{DSM personality disorders}}
{{Medical classification}}
{{italic title}}
[[Category:Diagnostic and Statistical Manual of Mental Disorders| ]]
[[Category:American Psychiatric Association]]
[[Category:Data coding framework]]
[[Category:Medical manuals]]
[[Category:Medical statistics]]
[[Category:Psychiatric assessment]]
[[Category:Classification of mental disorders]]
[[Category:Psychiatric diagnosis]]
[[Category:Psychopathology]]
[[Category:Publications established in 1952]]
[[Category:Statistical data coding]]' |
Unified diff of changes made by edit (edit_diff) | '@@ -115,5 +115,5 @@
==== DSM-IV Categorization ====
-The DSM-IV is a categorical classification system. The categories are prototypes, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<ref>{{cite journal | vauthors = Maser JD, Patterson T | title = Spectrum and nosology: implications for DSM-V | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = 855–885 | date = December 2002 | pmid = 12462864 | doi = 10.1016/s0193-953x(02)00022-9 }}</ref> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from [[tic disorder]]s and several of the [[paraphilia]]s due to their [[egosyntonic]] nature. Each category of disorder has a numeric code taken from the [[ICD coding system]], used for health service (including insurance) administrative purposes.
+The DSM-IV is a categorical classification system. The categories are sigma, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<ref>{{cite journal | vauthors = Maser JD, Patterson T | title = Spectrum and nosology: implications for DSM-V | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = 855–885 | date = December 2002 | pmid = 12462864 | doi = 10.1016/s0193-953x(02)00022-9 }}</ref> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from [[tic disorder]]s and several of the [[paraphilia]]s due to their [[egosyntonic]] nature. Each category of disorder has a numeric code taken from the [[ICD coding system]], used for health service (including insurance) administrative purposes.
==== {{anchor|DSM-IV-TR multi-axial system}}DSM-IV multi-axial system ====
' |
New page size (new_size) | 116035 |
Old page size (old_size) | 116040 |
Size change in edit (edit_delta) | -5 |
Lines added in edit (added_lines) | [
0 => 'The DSM-IV is a categorical classification system. The categories are sigma, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<ref>{{cite journal | vauthors = Maser JD, Patterson T | title = Spectrum and nosology: implications for DSM-V | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = 855–885 | date = December 2002 | pmid = 12462864 | doi = 10.1016/s0193-953x(02)00022-9 }}</ref> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from [[tic disorder]]s and several of the [[paraphilia]]s due to their [[egosyntonic]] nature. Each category of disorder has a numeric code taken from the [[ICD coding system]], used for health service (including insurance) administrative purposes.'
] |
Lines removed in edit (removed_lines) | [
0 => 'The DSM-IV is a categorical classification system. The categories are prototypes, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<ref>{{cite journal | vauthors = Maser JD, Patterson T | title = Spectrum and nosology: implications for DSM-V | journal = The Psychiatric Clinics of North America | volume = 25 | issue = 4 | pages = 855–885 | date = December 2002 | pmid = 12462864 | doi = 10.1016/s0193-953x(02)00022-9 }}</ref> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from [[tic disorder]]s and several of the [[paraphilia]]s due to their [[egosyntonic]] nature. Each category of disorder has a numeric code taken from the [[ICD coding system]], used for health service (including insurance) administrative purposes.'
] |
All external links added in the edit (added_links) | [] |
All external links removed in the edit (removed_links) | [] |
All external links in the new text (all_links) | [
0 => 'http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf',
1 => 'https://www.afr.com/policy/health-and-education/how-australia-adopted-america-s-bible-of-psychiatry-20210419-p57kjr',
2 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980454',
3 => 'https://doi.org/10.1002%2Fwps.20525',
4 => 'https://pubmed.ncbi.nlm.nih.gov/29856559',
5 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788',
6 => 'https://doi.org/10.1016%2FS0140-6736(17)32802-7',
7 => 'https://pubmed.ncbi.nlm.nih.gov/29477251',
8 => 'https://doi.org/10.1097%2FYIC.0000000000000078',
9 => 'https://www.worldcat.org/issn/0268-1315',
10 => 'https://pubmed.ncbi.nlm.nih.gov/25932596',
11 => 'https://api.semanticscholar.org/CorpusID:24088074',
12 => 'https://doi.org/10.1016%2FS0140-6736(21)01997-8',
13 => 'https://www.worldcat.org/issn/0140-6736',
14 => 'https://pubmed.ncbi.nlm.nih.gov/35219395',
15 => 'https://api.semanticscholar.org/CorpusID:247087411',
16 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478737',
17 => 'https://doi.org/10.1007%2Fs40263-021-00855-4',
18 => 'https://www.worldcat.org/issn/1172-7047',
19 => 'https://pubmed.ncbi.nlm.nih.gov/34495494',
20 => 'http://annals.org/article.aspx?articleid=1688399',
21 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802383',
22 => 'https://doi.org/10.4103%2F0019-5545.58302',
23 => 'https://pubmed.ncbi.nlm.nih.gov/20048461',
24 => 'https://doi.org/10.1176%2Fappi.ajp.160.1.4',
25 => 'https://pubmed.ncbi.nlm.nih.gov/12505793',
26 => 'https://api.semanticscholar.org/CorpusID:16151623',
27 => 'https://doi.org/10.1192%2Fbjp.bp.106.024026',
28 => 'https://pubmed.ncbi.nlm.nih.gov/17329740',
29 => 'https://api.semanticscholar.org/CorpusID:4888348',
30 => 'https://web.archive.org/web/20070929134334/http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145',
31 => 'https://doi.org/10.1001%2Farchpsyc.55.12.1145',
32 => 'https://pubmed.ncbi.nlm.nih.gov/9862559',
33 => 'http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145',
34 => 'https://doi.org/10.1176%2Fappi.ajp.2012.12070999',
35 => 'https://pubmed.ncbi.nlm.nih.gov/23111466',
36 => 'https://www.who.int/classifications/icd/en/bluebook.pdf',
37 => 'https://www.who.int/classifications/icd/en/GRNBOOK.pdf',
38 => 'https://doi.org/10.1159%2F000065122',
39 => 'https://pubmed.ncbi.nlm.nih.gov/12145487',
40 => 'https://api.semanticscholar.org/CorpusID:35857872',
41 => 'https://doi.org/10.1192%2Fapt.bp.113.011296',
42 => 'https://www.worldcat.org/issn/1355-5146',
43 => 'http://www.apa.org/monitor/2009/10/icd-dsm.aspx',
44 => 'https://www.who.int/entity/classifications/icd/en/GRNBOOK.pdf',
45 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1616226',
46 => 'https://doi.org/10.2307%2F4595007',
47 => 'https://www.jstor.org/stable/4595007',
48 => 'https://pubmed.ncbi.nlm.nih.gov/4274650',
49 => 'https://www.worldcat.org/issn/0022-1597',
50 => 'https://pubmed.ncbi.nlm.nih.gov/776775',
51 => 'https://collections.nlm.nih.gov/catalog/nlm:nlmuid-31910070R-bk',
52 => 'https://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf',
53 => 'https://web.archive.org/web/20110505192204/http://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf',
54 => 'https://www.jstor.org/stable/44450311',
55 => 'https://pubmed.ncbi.nlm.nih.gov/769874',
56 => 'https://sites.google.com/site/psych54000/a',
57 => 'https://web.archive.org/web/20130911021653/https://sites.google.com/site/psych54000/a',
58 => 'https://www.worldcat.org/oclc/13945621',
59 => 'https://archive.org/search.php?query=((subject:%22Bertillon,%20Jacques%22%20OR%20subject:%22Jacques%20Bertillon%22%20OR%20creator:%22Bertillon,%20Jacques%22%20OR%20creator:%22Jacques%20Bertillon%22%20OR%20creator:%22Bertillon,%20J.%22%20OR%20title:%22Jacques%20Bertillon%22%20OR%20description:%22Bertillon,%20Jacques%22%20OR%20description:%22Jacques%20Bertillon%22)%20OR%20(%221851-1922%22%20AND%20Bertillon))%20AND%20(-mediatype:software)',
60 => 'https://www.who.int/entity/classifications/icd/en/HistoryOfICD.pdf',
61 => 'https://wellcomecollection.org/works/u4swa3m3/',
62 => 'https://archive.org/details/statisticalmanu00assogoog',
63 => 'https://doi.org/10.1177%2F1529100617727266',
64 => 'https://pubmed.ncbi.nlm.nih.gov/29211974',
65 => 'https://api.semanticscholar.org/CorpusID:206743519',
66 => 'https://archive.org/details/dsm-1',
67 => 'https://journals.lww.com/jonmd/Citation/1933/12000/A_Standard_Classified_Nomenclature_of_Disease.75.aspx',
68 => 'https://doi.org/10.1097%2F00005053-193312000-00075',
69 => 'https://www.worldcat.org/issn/0022-3018',
70 => 'https://doi.org/10.1016%2Fj.ijlp.2004.01.001',
71 => 'https://pubmed.ncbi.nlm.nih.gov/15019764',
72 => 'https://books.google.com/books?id=BHEwAAAAIAAJ',
73 => 'https://web.archive.org/web/20200420113904/https://navymedicine.navylive.dodlive.mil/archives/7192',
74 => 'https://navymedicine.navylive.dodlive.mil/archives/7192',
75 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2015553',
76 => 'https://doi.org/10.1136%2Fbmj.1.4809.560',
77 => 'https://archive.today/20130105054908/http://www3.interscience.wiley.com/journal/72506618/abstract',
78 => 'https://doi.org/10.1002%2F1097-4679(200007)56:7%3C935::AID-JCLP11%3E3.0.CO;2-8',
79 => 'https://pubmed.ncbi.nlm.nih.gov/10902952',
80 => 'http://www3.interscience.wiley.com/journal/72506618/abstract',
81 => 'https://onlinelibrary.wiley.com/doi/10.1002/1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O',
82 => 'https://doi.org/10.1002%2F1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O',
83 => 'https://pubmed.ncbi.nlm.nih.gov/20992064',
84 => 'http://archive.org/details/NOMENCLATUREANDMETHODOFRECORDINGPSYCHIATRICCONDITIONS',
85 => 'https://doi.org/10.1176%2Fajp.148.4.421',
86 => 'https://pubmed.ncbi.nlm.nih.gov/2006685',
87 => 'https://archive.today/20120720080755/http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21',
88 => 'http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21',
89 => 'http://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf',
90 => 'https://books.google.com/books?id=drBejRLWkHkC&pg=PA76',
91 => 'https://doi.org/10.1002%2Fjhbs.20103',
92 => 'https://pubmed.ncbi.nlm.nih.gov/15981242',
93 => 'https://doi.org/10.1176%2Fajp.150.3.399',
94 => 'https://pubmed.ncbi.nlm.nih.gov/8434655',
95 => 'https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk&kutchins.htm',
96 => 'http://www.academyanalyticarts.org/kirk&kutchins.htm',
97 => 'https://doi.org/10.1192%2Fbjp.125.4.341',
98 => 'https://pubmed.ncbi.nlm.nih.gov/4425771',
99 => 'https://api.semanticscholar.org/CorpusID:37782257',
100 => 'https://archive.org/details/homosexualityame00bayerich',
101 => 'https://web.archive.org/web/20070810054520/http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809',
102 => 'https://doi.org/10.1176%2Fappi.ps.57.12.1809',
103 => 'https://pubmed.ncbi.nlm.nih.gov/17158503',
104 => 'https://api.semanticscholar.org/CorpusID:37419476',
105 => 'http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809',
106 => 'https://web.archive.org/web/20070630022511/http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a',
107 => 'https://doi.org/10.1176%2Fappi.ps.57.12.1809-a',
108 => 'http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a',
109 => 'https://doi.org/10.1176%2Fajp.138.2.210',
110 => 'https://pubmed.ncbi.nlm.nih.gov/7457641',
111 => 'https://pages.uoregon.edu/eherman/teaching/texts/DSM-II_Homosexuality_Revision.pdf',
112 => 'https://www.sciencedirect.com/science/article/abs/pii/S0272735898000026',
113 => 'https://doi.org/10.1016%2Fs0272-7358(98)00002-6',
114 => 'https://pubmed.ncbi.nlm.nih.gov/9740979',
115 => 'https://web.archive.org/web/20061212180933/http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact',
116 => 'http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact',
117 => 'https://web.archive.org/web/20100824224731/http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30',
118 => 'https://doi.org/10.1176%2Fajp.125.10s.21',
119 => 'https://pubmed.ncbi.nlm.nih.gov/5774702',
120 => 'http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30',
121 => 'https://archive.org/details/shynesshownormal00lane/page/263',
122 => 'https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf',
123 => 'https://doi.org/10.1111%2Fcamh.12361',
124 => 'https://pubmed.ncbi.nlm.nih.gov/32285632',
125 => 'https://api.semanticscholar.org/CorpusID:210484832',
126 => 'https://web.archive.org/web/20221128201913/https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf',
127 => 'http://www.thisamericanlife.org/radio-archives/episode/204/81-words',
128 => 'https://web.archive.org/web/20070323150804/http://www.acnp.org/G4/GN401000082/CH081.html',
129 => 'http://www.acnp.org/G4/GN401000082/CH081.html',
130 => 'https://doi.org/10.1177%2F070674379604100602',
131 => 'https://pubmed.ncbi.nlm.nih.gov/8862851',
132 => 'https://api.semanticscholar.org/CorpusID:28547523',
133 => 'https://www.psychologytoday.com/us/blog/rethinking-mental-health/201307/the-new-definition-mental-disorder',
134 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101504',
135 => 'https://doi.org/10.1017%2FS0033291709992261',
136 => 'https://pubmed.ncbi.nlm.nih.gov/20624327',
137 => 'https://doi.org/10.1016%2Fs0193-953x(02)00022-9',
138 => 'https://pubmed.ncbi.nlm.nih.gov/12462864',
139 => 'https://www.ncbi.nlm.nih.gov/books/NBK519711/',
140 => 'https://archive.org/details/dsmivsourcebook0000unse',
141 => 'https://web.archive.org/web/20131206233357/http://ajp.psychiatryonline.org/article.aspx?articleid=173760',
142 => 'https://doi.org/10.1176%2Fajp.156.10.1655',
143 => 'http://ajp.psychiatryonline.org/article.aspx?articleid=173760',
144 => 'https://web.archive.org/web/20050501182254/http://mentalhelp.net/books/books.php?type=de&id=557',
145 => 'http://mentalhelp.net/books/books.php?type=de&id=557',
146 => 'https://web.archive.org/web/20070927005022/http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74',
147 => 'http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74',
148 => 'https://behavenet.com/dsm-iv-replaced-dsm-iv-tr-changes-diagnostic-criteria',
149 => 'https://doi.org/10.1176%2Fappi.ps.53.3.288',
150 => 'https://pubmed.ncbi.nlm.nih.gov/11875221',
151 => 'http://www.medscape.com/viewarticle/775496',
152 => 'http://theconversation.com/explainer-what-is-the-dsm-14127',
153 => 'https://www.usatoday.com/story/news/nation/2013/05/12/dsm-psychiatry-mental-disorders/2150819/',
154 => 'http://www.huffingtonpost.com/2013/05/20/dsm5-changes-what-parents-need-to-know_n_3294413.html',
155 => 'http://tess2.uspto.gov/',
156 => 'https://web.archive.org/web/20150226050453/http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf',
157 => 'http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf',
158 => 'https://www.psychiatry.org/psychiatrists/practice/dsm',
159 => 'https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions',
160 => 'https://web.archive.org/web/20100613144808/http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx',
161 => 'http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx',
162 => 'https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2014.10a19',
163 => 'https://doi.org/10.1176%2Fappi.pn.2014.10a19',
164 => 'https://www.appi.org/products/dsm',
165 => 'https://doi.org/10.1176%2Fappi.ps.202100013',
166 => 'https://www.worldcat.org/issn/1075-2730',
167 => 'https://pubmed.ncbi.nlm.nih.gov/33882702',
168 => 'https://api.semanticscholar.org/CorpusID:233349377',
169 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077590',
170 => 'https://doi.org/10.1002%2Fwps.20989',
171 => 'https://www.worldcat.org/issn/1723-8617',
172 => 'https://pubmed.ncbi.nlm.nih.gov/35524596',
173 => 'https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/',
174 => 'https://www.worldcat.org/issn/0190-8286',
175 => 'https://doi.org/10.1037%2Fccp0000720.supp',
176 => 'https://www.worldcat.org/issn/0022-006X',
177 => 'https://api.semanticscholar.org/CorpusID:248338204',
178 => 'https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-criteria-text',
179 => 'https://dsm.psychiatryonline.org/',
180 => 'http://www.psychiatrictimes.com/blogs/couch-crisis/why-dsm-iii-iv-and-5-are-unscientific',
181 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060802',
182 => 'https://doi.org/10.3389%2Ffpsyg.2014.00602',
183 => 'https://pubmed.ncbi.nlm.nih.gov/24987385',
184 => 'https://web.archive.org/web/20130529152509/http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml',
185 => 'http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml',
186 => 'https://web.archive.org/web/20190223235629/https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml',
187 => 'https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml',
188 => 'http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5',
189 => 'https://web.archive.org/web/20130115024502/http://ajp.psychiatryonline.org/article.aspx?articleID=1555604',
190 => 'https://doi.org/10.1176%2Fappi.ajp.2012.12091189',
191 => 'https://pubmed.ncbi.nlm.nih.gov/23288382',
192 => 'http://ajp.psychiatryonline.org/article.aspx?articleid=1555604',
193 => 'https://doi.org/10.1001%2Fjama.293.20.2526',
194 => 'https://pubmed.ncbi.nlm.nih.gov/15914753',
195 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1801862',
196 => 'https://pubmed.ncbi.nlm.nih.gov/20313414',
197 => 'https://web.archive.org/web/20131205122638/http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html',
198 => 'http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html',
199 => 'https://doi.org/10.1037%2F0021-843x.108.3.453',
200 => 'https://pubmed.ncbi.nlm.nih.gov/10466269',
201 => 'https://doi.org/10.1016%2FS0005-7967(00)00068-1',
202 => 'https://pubmed.ncbi.nlm.nih.gov/11227812',
203 => 'https://doi.org/10.1080%2F00213624.2004.11506751',
204 => 'https://api.semanticscholar.org/CorpusID:141997867',
205 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668119',
206 => 'https://doi.org/10.1007%2Fs00406-012-0366-z',
207 => 'https://pubmed.ncbi.nlm.nih.gov/23001456',
208 => 'http://ref.scielo.org/w7qdd5',
209 => 'https://doi.org/10.17159%2F2309-8708%2F2015%2Fn48a1',
210 => 'http://journals.sagepub.com/doi/10.1177/0959353512467972',
211 => 'https://doi.org/10.1177%2F0959353512467972',
212 => 'https://www.worldcat.org/issn/0959-3535',
213 => 'https://www.cambridge.org/core/product/identifier/S0887536722000605/type/journal_article',
214 => 'https://doi.org/10.1017%2Fhyp.2022.60',
215 => 'https://www.worldcat.org/issn/0887-5367',
216 => 'https://direct.mit.edu/books/book/3043/Classifying-PsychopathologyMental-Kinds-and',
217 => 'https://doi.org/10.7551%2Fmitpress%2F8942.001.0001',
218 => 'https://www.jstor.org/stable/43853806',
219 => 'https://www.worldcat.org/issn/0271-0137',
220 => 'https://www.jstor.org/stable/43853630',
221 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273344',
222 => 'https://ui.adsabs.harvard.edu/abs/2014PNAS..11117786L',
223 => 'https://doi.org/10.1073%2Fpnas.1414058111',
224 => 'https://www.worldcat.org/issn/0027-8424',
225 => 'https://pubmed.ncbi.nlm.nih.gov/25453068',
226 => 'https://muse.jhu.edu/article/2437',
227 => 'https://doi.org/10.1353%2Faq.2000.0013',
228 => 'https://www.worldcat.org/issn/1080-6490',
229 => 'https://pubmed.ncbi.nlm.nih.gov/16858900',
230 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609238',
231 => 'https://doi.org/10.1111%2F1467-9566.12315',
232 => 'https://www.worldcat.org/issn/0141-9889',
233 => 'https://pubmed.ncbi.nlm.nih.gov/26385581',
234 => 'https://psychcentral.com/blog/overdiagnosis-mental-disorders-and-the-dsm-5/',
235 => 'https://www.psychologytoday.com/us/blog/dsm5-in-distress/201006/psychiatric-fads-and-overdiagnosis',
236 => 'http://www.bmj.com/cgi/content/short/348/jul01_1/g4377',
237 => 'https://doi.org/10.1136%2Fbmj.f6172',
238 => 'https://pubmed.ncbi.nlm.nih.gov/24192646',
239 => 'https://api.semanticscholar.org/CorpusID:32080132',
240 => 'https://doi.org/10.1037%2Fa0026582',
241 => 'https://pubmed.ncbi.nlm.nih.gov/22201328',
242 => 'https://api.semanticscholar.org/CorpusID:6436414',
243 => 'https://doi.org/10.1016%2Fj.jaac.2014.03.005',
244 => 'https://pubmed.ncbi.nlm.nih.gov/24954823',
245 => 'https://doi.org/10.1002%2Fmrdd.10029',
246 => 'https://pubmed.ncbi.nlm.nih.gov/12216059',
247 => 'https://web.archive.org/web/20030307205740/http://nyspi.org/AR2001/Biometrics.htm',
248 => 'http://nyspi.org/AR2001/Biometrics.htm',
249 => 'https://doi.org/10.1016%2FS0193-953X(02)00034-5',
250 => 'https://pubmed.ncbi.nlm.nih.gov/12462854',
251 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242426',
252 => 'https://doi.org/10.1037%2F0021-843X.114.4.491',
253 => 'https://pubmed.ncbi.nlm.nih.gov/16351372',
254 => 'https://doi.org/10.1001%2Farchpsyc.64.4.433',
255 => 'https://pubmed.ncbi.nlm.nih.gov/17404120',
256 => 'https://doi.org/10.1176%2Fajp.156.12.1856',
257 => 'https://pubmed.ncbi.nlm.nih.gov/10588397',
258 => 'https://api.semanticscholar.org/CorpusID:25642814',
259 => 'https://doi.org/10.1146%2Fannurev.psych.51.1.377',
260 => 'https://pubmed.ncbi.nlm.nih.gov/10751976',
261 => 'https://www.washingtonpost.com/wp-dyn/content/article/2005/06/25/AR2005062500982.html',
262 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116337',
263 => 'https://doi.org/10.1136%2Fbmj.319.7204.254',
264 => 'https://pubmed.ncbi.nlm.nih.gov/10417096',
265 => 'https://doi.org/10.3109%2F10673229709030563',
266 => 'https://pubmed.ncbi.nlm.nih.gov/9385013',
267 => 'https://api.semanticscholar.org/CorpusID:43256486',
268 => 'https://doi.org/10.1177%2F00957984910172002',
269 => 'https://api.semanticscholar.org/CorpusID:144458287',
270 => 'http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf',
271 => 'https://web.archive.org/web/20151121133043/http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf',
272 => 'http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf',
273 => 'https://web.archive.org/web/20160820114756/http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf',
274 => 'https://doi.org/10.3109%2F01612840.2012.704130',
275 => 'https://pubmed.ncbi.nlm.nih.gov/22957950',
276 => 'https://api.semanticscholar.org/CorpusID:3453154',
277 => 'http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1',
278 => 'https://web.archive.org/web/20090212110644/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1',
279 => 'https://doi.org/10.1159%2F000091772',
280 => 'https://pubmed.ncbi.nlm.nih.gov/16636630',
281 => 'https://api.semanticscholar.org/CorpusID:11909535',
282 => 'https://web.archive.org/web/20170626220701/http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html',
283 => 'http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html',
284 => 'https://www.nytimes.com/2012/01/30/opinion/the-dsms-troubled-revision.html',
285 => 'http://journals.sagepub.com/doi/10.1177/1049732310381388',
286 => 'https://doi.org/10.1177%2F1049732310381388',
287 => 'https://www.worldcat.org/issn/1049-7323',
288 => 'https://pubmed.ncbi.nlm.nih.gov/20739589',
289 => 'https://api.semanticscholar.org/CorpusID:1853974',
290 => 'http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf',
291 => 'https://web.archive.org/web/20140317045503/http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf',
292 => 'http://jhp.sagepub.com/cgi/content/abstract/41/4/36',
293 => 'https://madpridect.wordpress.com/2013/06/08/known-as-the-psychiatric-bible-the-diagnostic-and-statistical-manual-of-mental-disorders-appears-in-a-fifth-edition/',
294 => 'http://www.medscape.com/viewarticle/565489_print',
295 => 'https://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html',
296 => 'http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes',
297 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305603',
298 => 'https://doi.org/10.1186%2F1747-5341-7-3',
299 => 'https://pubmed.ncbi.nlm.nih.gov/22243994',
300 => 'https://web.archive.org/web/20120329184708/http://www.pointpark.edu/NewsArtsSciences.aspx?id=467',
301 => 'http://www.pointpark.edu/NewsArtsSciences.aspx?id=467',
302 => 'http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/26/MNJJ1M3DFK.DTL',
303 => 'https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf',
304 => 'https://books.google.com/books?id=3SQrtpnHb9MC',
305 => 'https://books.google.com/books?id=S_xe-AX4UjMC',
306 => 'http://www.dsm5.org/pages/default.aspx',
307 => 'http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm',
308 => 'https://archive.today/20120527015056/http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm',
309 => 'https://apicalhealth.com/illness-and-recovery/dsm-iv/',
310 => 'https://web.archive.org/web/20210116142849/https://apicalhealth.com/illness-and-recovery/dsm-iv/'
] |
Links in the page, before the edit (old_links) | [
0 => 'https://sites.google.com/site/psych54000/a',
1 => 'http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact',
2 => 'http://www.acnp.org/G4/GN401000082/CH081.html',
3 => 'http://www.medscape.com/viewarticle/775496',
4 => 'http://www.huffingtonpost.com/2013/05/20/dsm5-changes-what-parents-need-to-know_n_3294413.html',
5 => 'http://nyspi.org/AR2001/Biometrics.htm',
6 => 'http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf',
7 => 'http://jhp.sagepub.com/cgi/content/abstract/41/4/36',
8 => 'http://www.medscape.com/viewarticle/565489_print',
9 => 'http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml',
10 => 'http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html',
11 => 'http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes',
12 => 'http://www.pointpark.edu/NewsArtsSciences.aspx?id=467',
13 => 'http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/26/MNJJ1M3DFK.DTL',
14 => 'http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf',
15 => 'https://archive.org/details/statisticalmanu00assogoog',
16 => 'http://www.psychiatrictimes.com/blogs/couch-crisis/why-dsm-iii-iv-and-5-are-unscientific',
17 => 'http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf',
18 => 'http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf',
19 => 'https://web.archive.org/web/20061212180933/http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact',
20 => 'http://www.thisamericanlife.org/radio-archives/episode/204/81-words',
21 => 'http://theconversation.com/explainer-what-is-the-dsm-14127',
22 => 'https://web.archive.org/web/20100613144808/http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx',
23 => 'http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx',
24 => 'https://web.archive.org/web/20030307205740/http://nyspi.org/AR2001/Biometrics.htm',
25 => 'https://web.archive.org/web/20150226050453/http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf',
26 => 'https://www.usatoday.com/story/news/nation/2013/05/12/dsm-psychiatry-mental-disorders/2150819/',
27 => 'https://www.washingtonpost.com/wp-dyn/content/article/2005/06/25/AR2005062500982.html',
28 => 'http://www.apa.org/monitor/2009/10/icd-dsm.aspx',
29 => 'https://web.archive.org/web/20140317045503/http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf',
30 => 'https://web.archive.org/web/20120329184708/http://www.pointpark.edu/NewsArtsSciences.aspx?id=467',
31 => 'https://psychcentral.com/blog/overdiagnosis-mental-disorders-and-the-dsm-5/',
32 => 'https://www.psychologytoday.com/us/blog/dsm5-in-distress/201006/psychiatric-fads-and-overdiagnosis',
33 => 'https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml',
34 => 'http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5',
35 => 'https://www.nytimes.com/2012/01/30/opinion/the-dsms-troubled-revision.html',
36 => 'https://madpridect.wordpress.com/2013/06/08/known-as-the-psychiatric-bible-the-diagnostic-and-statistical-manual-of-mental-disorders-appears-in-a-fifth-edition/',
37 => 'https://www.psychiatry.org/psychiatrists/practice/dsm',
38 => 'https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions',
39 => 'https://navymedicine.navylive.dodlive.mil/archives/7192',
40 => 'http://tess2.uspto.gov/',
41 => 'https://archive.org/details/shynesshownormal00lane/page/263',
42 => 'https://books.google.com/books?id=3SQrtpnHb9MC',
43 => 'https://books.google.com/books?id=S_xe-AX4UjMC',
44 => 'https://api.semanticscholar.org/CorpusID:16151623',
45 => 'https://api.semanticscholar.org/CorpusID:35857872',
46 => 'https://api.semanticscholar.org/CorpusID:141997867',
47 => 'https://api.semanticscholar.org/CorpusID:32080132',
48 => 'https://api.semanticscholar.org/CorpusID:144458287',
49 => 'https://api.semanticscholar.org/CorpusID:3453154',
50 => 'https://api.semanticscholar.org/CorpusID:11909535',
51 => 'https://www.who.int/classifications/icd/en/bluebook.pdf',
52 => 'https://www.who.int/classifications/icd/en/GRNBOOK.pdf',
53 => 'https://apicalhealth.com/illness-and-recovery/dsm-iv/',
54 => 'https://behavenet.com/dsm-iv-replaced-dsm-iv-tr-changes-diagnostic-criteria',
55 => 'https://archive.org/details/dsmivsourcebook0000unse',
56 => 'https://web.archive.org/web/20131206233357/http://ajp.psychiatryonline.org/article.aspx?articleid=173760',
57 => 'http://ajp.psychiatryonline.org/article.aspx?articleid=173760',
58 => 'http://mentalhelp.net/books/books.php?type=de&id=557',
59 => 'https://web.archive.org/web/20050501182254/http://mentalhelp.net/books/books.php?type=de&id=557',
60 => 'http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74',
61 => 'https://web.archive.org/web/20070927005022/http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74',
62 => 'https://www.psychologytoday.com/us/blog/rethinking-mental-health/201307/the-new-definition-mental-disorder',
63 => 'https://api.semanticscholar.org/CorpusID:28547523',
64 => 'https://api.semanticscholar.org/CorpusID:43256486',
65 => 'https://api.semanticscholar.org/CorpusID:4888348',
66 => 'http://annals.org/article.aspx?articleid=1688399',
67 => 'https://web.archive.org/web/20070929134334/http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145',
68 => 'http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145',
69 => 'https://archive.today/20130105054908/http://www3.interscience.wiley.com/journal/72506618/abstract',
70 => 'http://www3.interscience.wiley.com/journal/72506618/abstract',
71 => 'https://archive.today/20120720080755/http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21',
72 => 'http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21',
73 => 'https://books.google.com/books?id=drBejRLWkHkC&pg=PA76',
74 => 'https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk&kutchins.htm',
75 => 'http://www.academyanalyticarts.org/kirk&kutchins.htm',
76 => 'https://web.archive.org/web/20070810054520/http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809',
77 => 'http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809',
78 => 'https://web.archive.org/web/20070630022511/http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a',
79 => 'http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a',
80 => 'https://web.archive.org/web/20100824224731/http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30',
81 => 'http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30',
82 => 'https://web.archive.org/web/20130115024502/http://ajp.psychiatryonline.org/article.aspx?articleID=1555604',
83 => 'http://ajp.psychiatryonline.org/article.aspx?articleid=1555604',
84 => 'https://web.archive.org/web/20131205122638/http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html',
85 => 'http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html',
86 => 'http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1',
87 => 'https://web.archive.org/web/20090212110644/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1',
88 => 'http://journals.sagepub.com/doi/10.1177/1049732310381388',
89 => 'https://pubmed.ncbi.nlm.nih.gov/776775',
90 => 'https://www.worldcat.org/oclc/13945621',
91 => 'https://www.jstor.org/stable/44450311',
92 => 'https://api.semanticscholar.org/CorpusID:206743519',
93 => 'http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm',
94 => 'https://web.archive.org/web/20210116142849/https://apicalhealth.com/illness-and-recovery/dsm-iv/',
95 => 'https://www.ncbi.nlm.nih.gov/books/NBK519711/',
96 => 'https://web.archive.org/web/20130529152509/http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml',
97 => 'https://www.who.int/entity/classifications/icd/en/GRNBOOK.pdf',
98 => 'https://api.semanticscholar.org/CorpusID:37782257',
99 => 'http://www.bmj.com/cgi/content/short/348/jul01_1/g4377',
100 => 'https://api.semanticscholar.org/CorpusID:1853974',
101 => 'https://www.appi.org/products/dsm',
102 => 'https://pages.uoregon.edu/eherman/teaching/texts/DSM-II_Homosexuality_Revision.pdf',
103 => 'https://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html',
104 => 'https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-criteria-text',
105 => 'https://archive.org/details/homosexualityame00bayerich',
106 => 'https://api.semanticscholar.org/CorpusID:233349377',
107 => 'https://api.semanticscholar.org/CorpusID:248338204',
108 => 'https://api.semanticscholar.org/CorpusID:37419476',
109 => 'https://api.semanticscholar.org/CorpusID:25642814',
110 => 'https://api.semanticscholar.org/CorpusID:210484832',
111 => 'https://web.archive.org/web/20200420113904/https://navymedicine.navylive.dodlive.mil/archives/7192',
112 => 'https://web.archive.org/web/20070323150804/http://www.acnp.org/G4/GN401000082/CH081.html',
113 => 'https://web.archive.org/web/20190223235629/https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml',
114 => 'https://web.archive.org/web/20170626220701/http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html',
115 => 'https://collections.nlm.nih.gov/catalog/nlm:nlmuid-31910070R-bk',
116 => 'https://journals.lww.com/jonmd/Citation/1933/12000/A_Standard_Classified_Nomenclature_of_Disease.75.aspx',
117 => 'https://dsm.psychiatryonline.org/',
118 => 'https://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf',
119 => 'https://wellcomecollection.org/works/u4swa3m3/',
120 => 'http://archive.org/details/NOMENCLATUREANDMETHODOFRECORDINGPSYCHIATRICCONDITIONS',
121 => 'https://onlinelibrary.wiley.com/doi/10.1002/1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O',
122 => 'https://books.google.com/books?id=BHEwAAAAIAAJ',
123 => 'https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf',
124 => 'https://web.archive.org/web/20110505192204/http://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf',
125 => 'https://web.archive.org/web/20221128201913/https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf',
126 => 'https://web.archive.org/web/20151121133043/http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf',
127 => 'https://web.archive.org/web/20160820114756/http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf',
128 => 'https://archive.org/details/dsm-1',
129 => 'https://archive.org/search.php?query=((subject:%22Bertillon,%20Jacques%22%20OR%20subject:%22Jacques%20Bertillon%22%20OR%20creator:%22Bertillon,%20Jacques%22%20OR%20creator:%22Jacques%20Bertillon%22%20OR%20creator:%22Bertillon,%20J.%22%20OR%20title:%22Jacques%20Bertillon%22%20OR%20description:%22Bertillon,%20Jacques%22%20OR%20description:%22Jacques%20Bertillon%22)%20OR%20(%221851-1922%22%20AND%20Bertillon))%20AND%20(-mediatype:software)',
130 => 'https://www.who.int/entity/classifications/icd/en/HistoryOfICD.pdf',
131 => 'https://api.semanticscholar.org/CorpusID:6436414',
132 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802383',
133 => 'https://doi.org/10.4103%2F0019-5545.58302',
134 => 'https://pubmed.ncbi.nlm.nih.gov/20048461',
135 => 'https://doi.org/10.1176%2Fappi.ajp.160.1.4',
136 => 'https://pubmed.ncbi.nlm.nih.gov/12505793',
137 => 'https://doi.org/10.1192%2Fbjp.bp.106.024026',
138 => 'https://pubmed.ncbi.nlm.nih.gov/17329740',
139 => 'https://doi.org/10.1001%2Farchpsyc.55.12.1145',
140 => 'https://pubmed.ncbi.nlm.nih.gov/9862559',
141 => 'https://doi.org/10.1159%2F000065122',
142 => 'https://pubmed.ncbi.nlm.nih.gov/12145487',
143 => 'https://doi.org/10.1192%2Fapt.bp.113.011296',
144 => 'https://www.worldcat.org/issn/1355-5146',
145 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1616226',
146 => 'https://doi.org/10.2307%2F4595007',
147 => 'https://www.jstor.org/stable/4595007',
148 => 'https://pubmed.ncbi.nlm.nih.gov/4274650',
149 => 'https://www.worldcat.org/issn/0022-1597',
150 => 'https://pubmed.ncbi.nlm.nih.gov/769874',
151 => 'https://doi.org/10.1177%2F1529100617727266',
152 => 'https://pubmed.ncbi.nlm.nih.gov/29211974',
153 => 'https://doi.org/10.1097%2F00005053-193312000-00075',
154 => 'https://www.worldcat.org/issn/0022-3018',
155 => 'https://doi.org/10.1016%2Fj.ijlp.2004.01.001',
156 => 'https://pubmed.ncbi.nlm.nih.gov/15019764',
157 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2015553',
158 => 'https://doi.org/10.1136%2Fbmj.1.4809.560',
159 => 'https://doi.org/10.1002%2F1097-4679(200007)56:7%3C935::AID-JCLP11%3E3.0.CO;2-8',
160 => 'https://pubmed.ncbi.nlm.nih.gov/10902952',
161 => 'https://doi.org/10.1002%2F1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O',
162 => 'https://pubmed.ncbi.nlm.nih.gov/20992064',
163 => 'https://doi.org/10.1176%2Fajp.148.4.421',
164 => 'https://pubmed.ncbi.nlm.nih.gov/2006685',
165 => 'https://doi.org/10.1002%2Fjhbs.20103',
166 => 'https://pubmed.ncbi.nlm.nih.gov/15981242',
167 => 'https://doi.org/10.1176%2Fajp.150.3.399',
168 => 'https://pubmed.ncbi.nlm.nih.gov/8434655',
169 => 'https://doi.org/10.1192%2Fbjp.125.4.341',
170 => 'https://pubmed.ncbi.nlm.nih.gov/4425771',
171 => 'https://doi.org/10.1176%2Fappi.ps.57.12.1809',
172 => 'https://pubmed.ncbi.nlm.nih.gov/17158503',
173 => 'https://doi.org/10.1176%2Fappi.ps.57.12.1809-a',
174 => 'https://doi.org/10.1176%2Fajp.138.2.210',
175 => 'https://pubmed.ncbi.nlm.nih.gov/7457641',
176 => 'https://doi.org/10.1176%2Fajp.125.10s.21',
177 => 'https://pubmed.ncbi.nlm.nih.gov/5774702',
178 => 'https://doi.org/10.1111%2Fcamh.12361',
179 => 'https://pubmed.ncbi.nlm.nih.gov/32285632',
180 => 'https://doi.org/10.1177%2F070674379604100602',
181 => 'https://pubmed.ncbi.nlm.nih.gov/8862851',
182 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101504',
183 => 'https://doi.org/10.1017%2FS0033291709992261',
184 => 'https://pubmed.ncbi.nlm.nih.gov/20624327',
185 => 'https://doi.org/10.1016%2Fs0193-953x(02)00022-9',
186 => 'https://pubmed.ncbi.nlm.nih.gov/12462864',
187 => 'https://doi.org/10.1176%2Fajp.156.10.1655',
188 => 'https://doi.org/10.1176%2Fappi.ps.53.3.288',
189 => 'https://pubmed.ncbi.nlm.nih.gov/11875221',
190 => 'https://doi.org/10.1176%2Fappi.ps.202100013',
191 => 'https://www.worldcat.org/issn/1075-2730',
192 => 'https://pubmed.ncbi.nlm.nih.gov/33882702',
193 => 'https://doi.org/10.1002%2Fwps.20989',
194 => 'https://www.worldcat.org/issn/1723-8617',
195 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077590',
196 => 'https://pubmed.ncbi.nlm.nih.gov/35524596',
197 => 'https://doi.org/10.1037%2Fccp0000720.supp',
198 => 'https://www.worldcat.org/issn/0022-006X',
199 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060802',
200 => 'https://doi.org/10.3389%2Ffpsyg.2014.00602',
201 => 'https://pubmed.ncbi.nlm.nih.gov/24987385',
202 => 'https://doi.org/10.1176%2Fappi.ajp.2012.12091189',
203 => 'https://pubmed.ncbi.nlm.nih.gov/23288382',
204 => 'https://doi.org/10.1001%2Fjama.293.20.2526',
205 => 'https://pubmed.ncbi.nlm.nih.gov/15914753',
206 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1801862',
207 => 'https://pubmed.ncbi.nlm.nih.gov/20313414',
208 => 'https://doi.org/10.1037%2F0021-843x.108.3.453',
209 => 'https://pubmed.ncbi.nlm.nih.gov/10466269',
210 => 'https://doi.org/10.1016%2FS0005-7967(00)00068-1',
211 => 'https://pubmed.ncbi.nlm.nih.gov/11227812',
212 => 'https://doi.org/10.1080%2F00213624.2004.11506751',
213 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668119',
214 => 'https://doi.org/10.1007%2Fs00406-012-0366-z',
215 => 'https://pubmed.ncbi.nlm.nih.gov/23001456',
216 => 'https://doi.org/10.1136%2Fbmj.f6172',
217 => 'https://pubmed.ncbi.nlm.nih.gov/24192646',
218 => 'https://doi.org/10.1037%2Fa0026582',
219 => 'https://pubmed.ncbi.nlm.nih.gov/22201328',
220 => 'https://doi.org/10.1016%2Fj.jaac.2014.03.005',
221 => 'https://pubmed.ncbi.nlm.nih.gov/24954823',
222 => 'https://doi.org/10.1002%2Fmrdd.10029',
223 => 'https://pubmed.ncbi.nlm.nih.gov/12216059',
224 => 'https://doi.org/10.1016%2FS0193-953X(02)00034-5',
225 => 'https://pubmed.ncbi.nlm.nih.gov/12462854',
226 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242426',
227 => 'https://doi.org/10.1037%2F0021-843X.114.4.491',
228 => 'https://pubmed.ncbi.nlm.nih.gov/16351372',
229 => 'https://doi.org/10.1001%2Farchpsyc.64.4.433',
230 => 'https://pubmed.ncbi.nlm.nih.gov/17404120',
231 => 'https://doi.org/10.1176%2Fajp.156.12.1856',
232 => 'https://pubmed.ncbi.nlm.nih.gov/10588397',
233 => 'https://doi.org/10.1146%2Fannurev.psych.51.1.377',
234 => 'https://pubmed.ncbi.nlm.nih.gov/10751976',
235 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116337',
236 => 'https://doi.org/10.1136%2Fbmj.319.7204.254',
237 => 'https://pubmed.ncbi.nlm.nih.gov/10417096',
238 => 'https://doi.org/10.3109%2F10673229709030563',
239 => 'https://pubmed.ncbi.nlm.nih.gov/9385013',
240 => 'https://doi.org/10.1177%2F00957984910172002',
241 => 'https://doi.org/10.3109%2F01612840.2012.704130',
242 => 'https://pubmed.ncbi.nlm.nih.gov/22957950',
243 => 'https://doi.org/10.1159%2F000091772',
244 => 'https://pubmed.ncbi.nlm.nih.gov/16636630',
245 => 'https://doi.org/10.1177%2F1049732310381388',
246 => 'https://www.worldcat.org/issn/1049-7323',
247 => 'https://pubmed.ncbi.nlm.nih.gov/20739589',
248 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305603',
249 => 'https://doi.org/10.1186%2F1747-5341-7-3',
250 => 'https://pubmed.ncbi.nlm.nih.gov/22243994',
251 => 'https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf',
252 => 'http://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf',
253 => 'https://web.archive.org/web/20130911021653/https://sites.google.com/site/psych54000/a',
254 => 'https://doi.org/10.1176%2Fappi.ajp.2012.12070999',
255 => 'https://doi.org/10.1002%2Fwps.20525',
256 => 'https://pubmed.ncbi.nlm.nih.gov/29856559',
257 => 'https://doi.org/10.1016%2FS0140-6736(17)32802-7',
258 => 'https://pubmed.ncbi.nlm.nih.gov/29477251',
259 => 'https://doi.org/10.1097%2FYIC.0000000000000078',
260 => 'https://www.worldcat.org/issn/0268-1315',
261 => 'https://doi.org/10.1016%2FS0140-6736(21)01997-8',
262 => 'https://www.worldcat.org/issn/0140-6736',
263 => 'https://doi.org/10.1007%2Fs40263-021-00855-4',
264 => 'https://www.worldcat.org/issn/1172-7047',
265 => 'https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2014.10a19',
266 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980454',
267 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788',
268 => 'https://pubmed.ncbi.nlm.nih.gov/25932596',
269 => 'https://api.semanticscholar.org/CorpusID:24088074',
270 => 'https://pubmed.ncbi.nlm.nih.gov/35219395',
271 => 'https://api.semanticscholar.org/CorpusID:247087411',
272 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478737',
273 => 'https://pubmed.ncbi.nlm.nih.gov/34495494',
274 => 'https://pubmed.ncbi.nlm.nih.gov/23111466',
275 => 'https://doi.org/10.1176%2Fappi.pn.2014.10a19',
276 => 'https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/',
277 => 'https://www.worldcat.org/issn/0190-8286',
278 => 'http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf',
279 => 'https://doi.org/10.1016%2Fs0272-7358(98)00002-6',
280 => 'https://www.sciencedirect.com/science/article/abs/pii/S0272735898000026',
281 => 'https://pubmed.ncbi.nlm.nih.gov/9740979',
282 => 'https://archive.today/20120527015056/http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm',
283 => 'http://www.dsm5.org/pages/default.aspx',
284 => 'https://www.afr.com/policy/health-and-education/how-australia-adopted-america-s-bible-of-psychiatry-20210419-p57kjr',
285 => 'https://doi.org/10.17159%2F2309-8708%2F2015%2Fn48a1',
286 => 'https://doi.org/10.1177%2F0959353512467972',
287 => 'https://doi.org/10.1017%2Fhyp.2022.60',
288 => 'https://doi.org/10.7551%2Fmitpress%2F8942.001.0001',
289 => 'https://www.worldcat.org/issn/0959-3535',
290 => 'https://www.worldcat.org/issn/0887-5367',
291 => 'https://www.worldcat.org/issn/0271-0137',
292 => 'https://www.jstor.org/stable/43853806',
293 => 'https://www.jstor.org/stable/43853630',
294 => 'http://ref.scielo.org/w7qdd5',
295 => 'http://journals.sagepub.com/doi/10.1177/0959353512467972',
296 => 'https://www.cambridge.org/core/product/identifier/S0887536722000605/type/journal_article',
297 => 'https://direct.mit.edu/books/book/3043/Classifying-PsychopathologyMental-Kinds-and',
298 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273344',
299 => 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609238',
300 => 'https://doi.org/10.1073%2Fpnas.1414058111',
301 => 'https://doi.org/10.1353%2Faq.2000.0013',
302 => 'https://doi.org/10.1111%2F1467-9566.12315',
303 => 'https://pubmed.ncbi.nlm.nih.gov/25453068',
304 => 'https://pubmed.ncbi.nlm.nih.gov/26385581',
305 => 'https://www.worldcat.org/issn/0027-8424',
306 => 'https://www.worldcat.org/issn/1080-6490',
307 => 'https://www.worldcat.org/issn/0141-9889',
308 => 'https://muse.jhu.edu/article/2437',
309 => 'https://pubmed.ncbi.nlm.nih.gov/16858900',
310 => 'https://ui.adsabs.harvard.edu/abs/2014PNAS..11117786L'
] |
Parsed HTML source of the new revision (new_html) | '<div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">American psychiatric classification</div>
<p class="mw-empty-elt">
</p>
<figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:DiagnosticAndStatisticalManualOfMentalDisorders.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/9/9a/DiagnosticAndStatisticalManualOfMentalDisorders.jpg/220px-DiagnosticAndStatisticalManualOfMentalDisorders.jpg" decoding="async" width="220" height="350" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/9/9a/DiagnosticAndStatisticalManualOfMentalDisorders.jpg 1.5x" data-file-width="250" data-file-height="398" /></a><figcaption>1952 edition of the DSM (DSM-I)</figcaption></figure>
<p>The <i><b>Diagnostic and Statistical Manual of Mental Disorders</b></i> (<i><b>DSM</b></i>; latest edition: <i><a href="/wiki/DSM-5-TR" class="mw-redirect" title="DSM-5-TR">DSM-5-TR</a></i>, published in March 2022<sup id="cite_ref-:1_1-0" class="reference"><a href="#cite_note-:1-1">[1]</a></sup>) is a publication by the <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a> (APA) for the <a href="/wiki/Classification_of_mental_disorders" title="Classification of mental disorders">classification of mental disorders</a> using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the <a href="/wiki/United_States" title="United States">United States</a> and <a href="/wiki/Australia" title="Australia">Australia</a>,<sup id="cite_ref-2" class="reference"><a href="#cite_note-2">[2]</a></sup> while in other countries it may be used in conjunction with other documents. The DSM-5 is considered one of the principal guides of psychiatry, along with the <a href="/wiki/International_Classification_of_Diseases" title="International Classification of Diseases">International Classification of Diseases</a> (ICD), <a href="/wiki/Chinese_Classification_of_Mental_Disorders" title="Chinese Classification of Mental Disorders">Chinese Classification of Mental Disorders</a> (CCMD), and the <i><a href="/wiki/Psychodynamic_Diagnostic_Manual" title="Psychodynamic Diagnostic Manual">Psychodynamic Diagnostic Manual</a></i>. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world<sup id="cite_ref-Do_mental_health_professionals_use_diagnostic_classifications_the_way_we_think_they_do?_A_global_survey_3-0" class="reference"><a href="#cite_note-Do_mental_health_professionals_use_diagnostic_classifications_the_way_we_think_they_do?_A_global_survey-3">[3]</a></sup> and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.<sup id="cite_ref-Comparative_efficacy_and_acceptability_of_21_antidepressant_drugs_for_the_acute_treatment_of_adults_with_major_depressive_disorder:_a_systematic_review_and_network_meta-analysis_4-0" class="reference"><a href="#cite_note-Comparative_efficacy_and_acceptability_of_21_antidepressant_drugs_for_the_acute_treatment_of_adults_with_major_depressive_disorder:_a_systematic_review_and_network_meta-analysis-4">[4]</a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5">[5]</a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6">[6]</a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7">[7]</a></sup>
</p><p>It is used by researchers, <a href="/wiki/Psychiatric_drug" class="mw-redirect" title="Psychiatric drug">psychiatric drug</a> regulation agencies, <a href="/wiki/Health_insurance" title="Health insurance">health insurance</a> companies, <a href="/wiki/Pharmaceutical_companies" class="mw-redirect" title="Pharmaceutical companies">pharmaceutical companies</a>, the legal system, and policymakers. Some mental health professionals use the manual to determine and help communicate a patient's diagnosis after an evaluation. Hospitals, clinics, and insurance companies in the United States may require a DSM diagnosis for all patients with mental disorders. Health-care researchers use the DSM to categorize patients for research purposes.
</p><p>The DSM evolved from systems for collecting census and <a href="/wiki/Psychiatric_hospital" title="Psychiatric hospital">psychiatric hospital</a> statistics, as well as from a <a href="/wiki/United_States_Army" title="United States Army">United States Army</a> manual. Revisions since its first publication in 1952 have incrementally added to the total number of <a href="/wiki/Mental_disorders" class="mw-redirect" title="Mental disorders">mental disorders</a>, while removing those no longer considered to be mental disorders.
</p><p>Recent editions of the DSM have received praise for standardizing psychiatric diagnosis grounded in empirical evidence, as opposed to the theory-bound <a href="/wiki/Nosology" title="Nosology">nosology</a> (the branch of <a href="/wiki/Medical_science" class="mw-redirect" title="Medical science">medical science</a> that deals with the <a href="/wiki/Medical_classification" title="Medical classification">classification of diseases</a>) used in DSM-III.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="Reads as more of a marketing statement than academically sound claim. A citation from the APA declaring itself to be an authority would not be sufficient backing for this claim. (April 2023)">citation needed</span></a></i>]</sup> However, it has also generated <a href="#Criticisms">controversy and criticism</a>, including ongoing questions concerning the <a href="/wiki/Reliability_(statistics)" title="Reliability (statistics)">reliability</a> and <a href="/wiki/Validity_(statistics)" title="Validity (statistics)">validity</a> of many diagnoses; the use of arbitrary dividing lines between mental illness and "<a href="/wiki/Normality_(behavior)" title="Normality (behavior)">normality</a>"; possible <a href="/wiki/Cultural_bias" title="Cultural bias">cultural bias</a>; and the <a href="/wiki/Medicalization" title="Medicalization">medicalization</a> of human distress.<sup id="cite_ref-frana_8-0" class="reference"><a href="#cite_note-frana-8">[8]</a></sup><sup id="cite_ref-concept&evolution_9-0" class="reference"><a href="#cite_note-concept&evolution-9">[9]</a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10">[10]</a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11">[11]</a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12">[12]</a></sup> The APA itself has published that the inter-rater reliability is low for many disorders in the DSM-5, including <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">major depressive disorder</a> and <a href="/wiki/Generalized_anxiety_disorder" title="Generalized anxiety disorder">generalized anxiety disorder</a>.<sup id="cite_ref-DSM-5_Field_Trials_in_the_United_States_and_Canada,_Part_II:_Test-Retest_Reliability_of_Selected_Categorical_Diagnoses_13-0" class="reference"><a href="#cite_note-DSM-5_Field_Trials_in_the_United_States_and_Canada,_Part_II:_Test-Retest_Reliability_of_Selected_Categorical_Diagnoses-13">[13]</a></sup>
</p>
<div id="toc" class="toc" role="navigation" aria-labelledby="mw-toc-heading"><input type="checkbox" role="button" id="toctogglecheckbox" class="toctogglecheckbox" style="display:none" /><div class="toctitle" lang="en" dir="ltr"><h2 id="mw-toc-heading">Contents</h2><span class="toctogglespan"><label class="toctogglelabel" for="toctogglecheckbox"></label></span></div>
<ul>
<li class="toclevel-1 tocsection-1"><a href="#Distinction_from_ICD"><span class="tocnumber">1</span> <span class="toctext">Distinction from ICD</span></a></li>
<li class="toclevel-1 tocsection-2"><a href="#Antecedents_(1840–1949)"><span class="tocnumber">2</span> <span class="toctext">Antecedents (1840–1949)</span></a>
<ul>
<li class="toclevel-2 tocsection-3"><a href="#Census_Office,_AMA_and_ISI_(1840–1911)"><span class="tocnumber">2.1</span> <span class="toctext">Census Office, AMA and ISI (1840–1911)</span></a></li>
<li class="toclevel-2 tocsection-4"><a href="#APA_Statistical_Manual_(1917)_and_AMA_Standard_(1933)"><span class="tocnumber">2.2</span> <span class="toctext">APA Statistical Manual (1917) and AMA Standard (1933)</span></a></li>
<li class="toclevel-2 tocsection-5"><a href="#Medical_203_(1945)"><span class="tocnumber">2.3</span> <span class="toctext">Medical 203 (1945)</span></a></li>
<li class="toclevel-2 tocsection-6"><a href="#ICD-6_(1948)"><span class="tocnumber">2.4</span> <span class="toctext">ICD-6 (1948)</span></a></li>
</ul>
</li>
<li class="toclevel-1 tocsection-7"><a href="#Early_versions_(20th_century)"><span class="tocnumber">3</span> <span class="toctext">Early versions (20th century)</span></a>
<ul>
<li class="toclevel-2 tocsection-8"><a href="#DSM-I_(1952)"><span class="tocnumber">3.1</span> <span class="toctext">DSM-I (1952)</span></a></li>
<li class="toclevel-2 tocsection-9"><a href="#DSM-II_(1968)"><span class="tocnumber">3.2</span> <span class="toctext">DSM-II (1968)</span></a>
<ul>
<li class="toclevel-3 tocsection-10"><a href="#Seventh_printing_of_the_DSM-II_(1974)"><span class="tocnumber">3.2.1</span> <span class="toctext">Seventh printing of the DSM-II (1974)</span></a></li>
</ul>
</li>
<li class="toclevel-2 tocsection-11"><a href="#DSM-III_(1980)"><span class="tocnumber">3.3</span> <span class="toctext">DSM-III (1980)</span></a></li>
<li class="toclevel-2 tocsection-12"><a href="#DSM-III-R_(1987)"><span class="tocnumber">3.4</span> <span class="toctext">DSM-III-R (1987)</span></a></li>
<li class="toclevel-2 tocsection-13"><a href="#DSM-IV_(1994)"><span class="tocnumber">3.5</span> <span class="toctext">DSM-IV (1994)</span></a>
<ul>
<li class="toclevel-3 tocsection-14"><a href="#DSM-IV_Definitions"><span class="tocnumber">3.5.1</span> <span class="toctext">DSM-IV Definitions</span></a></li>
<li class="toclevel-3 tocsection-15"><a href="#DSM-IV_Categorization"><span class="tocnumber">3.5.2</span> <span class="toctext">DSM-IV Categorization</span></a></li>
<li class="toclevel-3 tocsection-16"><a href="#DSM-IV_multi-axial_system"><span class="tocnumber">3.5.3</span> <span class="toctext">DSM-IV multi-axial system</span></a></li>
<li class="toclevel-3 tocsection-17"><a href="#DSM-IV_Sourcebooks"><span class="tocnumber">3.5.4</span> <span class="toctext">DSM-IV Sourcebooks</span></a></li>
</ul>
</li>
<li class="toclevel-2 tocsection-18"><a href="#DSM-IV-TR_(2000)"><span class="tocnumber">3.6</span> <span class="toctext">DSM-IV-TR (2000)</span></a></li>
</ul>
</li>
<li class="toclevel-1 tocsection-19"><a href="#DSM-5_(2013)"><span class="tocnumber">4</span> <span class="toctext">DSM-5 (2013)</span></a>
<ul>
<li class="toclevel-2 tocsection-20"><a href="#Future_revisions_and_updates"><span class="tocnumber">4.1</span> <span class="toctext">Future revisions and updates</span></a></li>
<li class="toclevel-2 tocsection-21"><a href="#DSM-5-TR_(2022)"><span class="tocnumber">4.2</span> <span class="toctext">DSM-5-TR (2022)</span></a></li>
</ul>
</li>
<li class="toclevel-1 tocsection-22"><a href="#DSM_Library"><span class="tocnumber">5</span> <span class="toctext">DSM Library</span></a></li>
<li class="toclevel-1 tocsection-23"><a href="#Criticisms"><span class="tocnumber">6</span> <span class="toctext">Criticisms</span></a>
<ul>
<li class="toclevel-2 tocsection-24"><a href="#Reliability_and_validity"><span class="tocnumber">6.1</span> <span class="toctext">Reliability and validity</span></a></li>
<li class="toclevel-2 tocsection-25"><a href="#Diagnosis_based_on_superficial_symptoms"><span class="tocnumber">6.2</span> <span class="toctext">Diagnosis based on superficial symptoms</span></a></li>
<li class="toclevel-2 tocsection-26"><a href="#Obscuring_root_causes"><span class="tocnumber">6.3</span> <span class="toctext">Obscuring root causes</span></a>
<ul>
<li class="toclevel-3 tocsection-27"><a href="#Economic_causes"><span class="tocnumber">6.3.1</span> <span class="toctext">Economic causes</span></a></li>
<li class="toclevel-3 tocsection-28"><a href="#Institutional_causes"><span class="tocnumber">6.3.2</span> <span class="toctext">Institutional causes</span></a></li>
</ul>
</li>
<li class="toclevel-2 tocsection-29"><a href="#Overdiagnosis"><span class="tocnumber">6.4</span> <span class="toctext">Overdiagnosis</span></a></li>
<li class="toclevel-2 tocsection-30"><a href="#Dividing_lines"><span class="tocnumber">6.5</span> <span class="toctext">Dividing lines</span></a></li>
<li class="toclevel-2 tocsection-31"><a href="#Cultural_bias"><span class="tocnumber">6.6</span> <span class="toctext">Cultural bias</span></a></li>
<li class="toclevel-2 tocsection-32"><a href="#Medicalization_and_financial_conflicts_of_interest"><span class="tocnumber">6.7</span> <span class="toctext">Medicalization and financial conflicts of interest</span></a></li>
<li class="toclevel-2 tocsection-33"><a href="#Potential_harm_of_labels"><span class="tocnumber">6.8</span> <span class="toctext">Potential harm of labels</span></a></li>
<li class="toclevel-2 tocsection-34"><a href="#Critiques_of_DSM-5"><span class="tocnumber">6.9</span> <span class="toctext">Critiques of DSM-5</span></a></li>
</ul>
</li>
<li class="toclevel-1 tocsection-35"><a href="#See_also"><span class="tocnumber">7</span> <span class="toctext">See also</span></a></li>
<li class="toclevel-1 tocsection-36"><a href="#Notes"><span class="tocnumber">8</span> <span class="toctext">Notes</span></a></li>
<li class="toclevel-1 tocsection-37"><a href="#References"><span class="tocnumber">9</span> <span class="toctext">References</span></a></li>
<li class="toclevel-1 tocsection-38"><a href="#Further_reading"><span class="tocnumber">10</span> <span class="toctext">Further reading</span></a></li>
<li class="toclevel-1 tocsection-39"><a href="#External_links"><span class="tocnumber">11</span> <span class="toctext">External links</span></a></li>
</ul>
</div>
<h2><span class="mw-headline" id="Distinction_from_ICD">Distinction from ICD</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=1" title="Edit section: Distinction from ICD"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p>An alternate, widely used classification publication is the <i><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">International Classification of Diseases</a></i> (ICD) is produced by the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> (WHO).<sup id="cite_ref-14" class="reference"><a href="#cite_note-14">[14]</a></sup> The ICD has a broader scope than the DSM, covering overall health as well as mental health; chapter 5 of the ICD specifically covers mental and behavioral disorders. Moreover, while the DSM is the most popular diagnostic system for mental disorders in the US, the ICD is used more widely in Europe and other parts of the world, giving it a far larger reach than the DSM. An international survey of psychiatrists in sixty-six countries compared the use of the <a href="/wiki/ICD-10" title="ICD-10">ICD-10</a> and DSM-IV. It found the former was more often used for clinical diagnosis while the latter was more valued for research.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15">[15]</a></sup> This may be because the DSM tends to put more emphasis on clear diagnostic criteria, while the ICD tends to put more emphasis on clinician judgement and avoiding diagnostic criteria unless they are independently validated. That is, the ICD descriptions of psychiatric disorders tend to be more qualitative information, such as general descriptions of what various disorders tend to look like. The DSM focuses more on quantitative and operationalized criteria; e.g. to be diagnosed with X disorder, one must fulfill 5 of 9 criteria for at least 6 months.<sup id="cite_ref-:2_16-0" class="reference"><a href="#cite_note-:2-16">[16]</a></sup>
</p><p>The <a href="/wiki/DSM-IV-TR_codes" class="mw-redirect" title="DSM-IV-TR codes">DSM-IV-TR</a> (4th ed.) contains specific codes allowing comparisons between the DSM and the ICD manuals, which may not systematically match because revisions are not simultaneously coordinated.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17">[17]</a></sup> Though recent editions of the DSM and ICD have become more similar due to collaborative agreements, each one contains information absent from the other.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18">[18]</a></sup> For instance, the two manuals contain overlapping but substantially different lists of recognized <a href="/wiki/Culture-bound_syndrome" title="Culture-bound syndrome">culture-bound syndromes</a>.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19">[19]</a></sup> The ICD also tends to focus more on primary-care and low and middle-income countries, as opposed to the DSM's focus on secondary psychiatric care in high-income countries.<sup id="cite_ref-:2_16-1" class="reference"><a href="#cite_note-:2-16">[16]</a></sup>
</p>
<h2><span id="Antecedents_.281840.E2.80.931949.29"></span><span class="mw-headline" id="Antecedents_(1840–1949)">Antecedents (1840–1949)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=2" title="Edit section: Antecedents (1840–1949)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<h3><span id="Census_Office.2C_AMA_and_ISI_.281840.E2.80.931911.29"></span><span class="mw-headline" id="Census_Office,_AMA_and_ISI_(1840–1911)">Census Office, AMA and ISI (1840–1911)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=3" title="Edit section: Census Office, AMA and ISI (1840–1911)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>The initial impetus for developing a classification of mental disorders in the United States was the need to collect statistical information. The first official attempt was the <a href="/wiki/United_States_census,_1840" class="mw-redirect" title="United States census, 1840">1840 census</a>, which used a single category: "<a href="/wiki/Idiocy" class="mw-redirect" title="Idiocy">idiocy</a>/<a href="/wiki/Insanity" title="Insanity">insanity</a>". Three years later, the <a href="/wiki/American_Statistical_Association" title="American Statistical Association">American Statistical Association</a> made an official protest to the <a href="/wiki/U.S._House_of_Representatives" class="mw-redirect" title="U.S. House of Representatives">U.S. House of Representatives</a>, stating that "the most glaring and remarkable errors are found in the statements respecting <a href="/wiki/Nosology" title="Nosology">nosology</a>, prevalence of insanity, blindness, deafness, and dumbness, among the people of this nation", pointing out that in many towns <a href="/wiki/African_Americans" title="African Americans">African Americans</a> were all marked as insane, and calling the statistics essentially useless.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20">[20]</a></sup>
</p><p>The <a href="/wiki/Association_of_Medical_Superintendents_of_American_Institutions_for_the_Insane" title="Association of Medical Superintendents of American Institutions for the Insane">Association of Medical Superintendents of American Institutions for the Insane</a> ("The Superintendents' Association") was formed in 1844.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21">[21]</a></sup>
</p><p>In 1860, during the international statistical congress held in London, <a href="/wiki/Florence_Nightingale" title="Florence Nightingale">Florence Nightingale</a> made a proposal that was to result in the development of the first international model of systematic collection of hospital data.
</p><p>In 1872, the <a href="/wiki/American_Medical_Association" title="American Medical Association">American Medical Association</a> (AMA) published its <i>Nomenclature of Diseases</i>, which included various "Disorders of the Intellect".<sup id="cite_ref-22" class="reference"><a href="#cite_note-22">[22]</a></sup> Its use was short-lived however.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23">[23]</a></sup>
</p><p>Edward Jarvis and later <a href="/wiki/Francis_Amasa_Walker" title="Francis Amasa Walker">Francis Amasa Walker</a> helped expand the census, from two volumes in 1870 to twenty-five volumes in 1880.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24">[24]</a></sup>
</p><p>In 1888, the <a href="/wiki/United_States_Census_Bureau" title="United States Census Bureau">Census Office</a> published Frederick H. Wines' 582-page volume called <i>Report on the Defective, Dependent, and Delinquent Classes of the Population of the United States, As Returned at the Tenth Census (June 1, 1880)</i>. Wines used seven categories of mental illness, which were also adopted by the Superintendents: <a href="/wiki/Dementia" title="Dementia">dementia</a>, <a href="/wiki/Dipsomania" title="Dipsomania">dipsomania</a> (uncontrollable craving for alcohol), <a href="/wiki/Epilepsy" title="Epilepsy">epilepsy</a>, <a href="/wiki/Mania" title="Mania">mania</a>, <a href="/wiki/Melancholia" title="Melancholia">melancholia</a>, <a href="/wiki/Monomania" title="Monomania">monomania</a>, and <a href="/wiki/Paresis" title="Paresis">paresis</a>.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25">[25]</a></sup>
</p><p>In 1892, the Superintendents' Association expanded its membership to include other mental health workers, and renamed to the <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Medico-Psychological Association</a> (AMPA).<sup id="cite_ref-26" class="reference"><a href="#cite_note-26">[26]</a></sup>
</p><p>In 1893, a French physician, <a href="/wiki/Jacques_Bertillon" title="Jacques Bertillon">Jacques Bertillon</a>, introduced the <i>Bertillon Classification of Causes of Death</i> at a congress of the <a href="/wiki/International_Statistical_Institute" title="International Statistical Institute">International Statistical Institute</a> (ISI) in Chicago.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27">[27]</a></sup><sup id="cite_ref-History_28-0" class="reference"><a href="#cite_note-History-28">[28]</a></sup> (The ISI had commissioned him to create it in 1891).<sup id="cite_ref-History_28-1" class="reference"><a href="#cite_note-History-28">[28]</a></sup> A number of countries adopted the ISI's system. In 1898, the <a href="/wiki/American_Public_Health_Association" title="American Public Health Association">American Public Health Association</a> (APHA) recommended that United States registrars also adopt the system.<sup id="cite_ref-History_28-2" class="reference"><a href="#cite_note-History-28">[28]</a></sup>
</p><p>In 1900, an ISI conference in Paris reformed the Bertillion Classification, and created the <i><a href="/wiki/International_Classification_of_Diseases" title="International Classification of Diseases">International List of Causes of Death</a></i> (ILCD)<i>.<sup id="cite_ref-History_28-3" class="reference"><a href="#cite_note-History-28">[28]</a></sup></i> Another conference would be held every ten years, and a new edition of the ILCD would be released. Five were ultimately issued. Non-fatal conditions were not included.
</p><p>In 1903, New York's <a href="/wiki/Bellevue_Hospital" title="Bellevue Hospital">Bellevue Hospital</a> published "The Bellevue Hospital nomenclature of diseases and conditions", which included a section on "Diseases of the Mind". Revisions were released in 1909 and 1911. It was produced with the assistance of the AMA and Bureau of the Census.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29">[29]</a></sup>
</p>
<h3><span id="APA_Statistical_Manual_.281917.29_and_AMA_Standard_.281933.29"></span><span class="mw-headline" id="APA_Statistical_Manual_(1917)_and_AMA_Standard_(1933)">APA Statistical Manual (1917) and AMA Standard (1933)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=4" title="Edit section: APA Statistical Manual (1917) and AMA Standard (1933)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>In 1917, together with the National Commission on Mental Hygiene (now <a href="/wiki/Mental_Health_America" class="mw-redirect" title="Mental Health America">Mental Health America</a>), the American Medico-Psychological Association developed a new guide for mental hospitals called the <i>Statistical Manual for the Use of Institutions for the Insane</i>. This guide included twenty-two diagnoses. It would be revised several times by the Association, and by the tenth edition in 1942, was titled <i>Statistical Manual for the Use of Hospitals of Mental Diseases</i>.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30">[30]</a></sup><sup id="cite_ref-31" class="reference"><a href="#cite_note-31">[31]</a></sup>
</p><p>In 1921, the AMPA became the present <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a> (APA).<sup id="cite_ref-32" class="reference"><a href="#cite_note-32">[32]</a></sup>
</p><p>The first edition of the DSM notes in its foreword: "In the late twenties, each large teaching center employed a system of its own origination, no one of which met more than the immediate needs of the local institution."<sup id="cite_ref-:8_33-0" class="reference"><a href="#cite_note-:8-33">[33]</a></sup>
</p><p>In 1933, the AMA's general medical guide the <i>Standard Classified Nomenclature of Disease</i>, (referred to as the <i>Standard),</i> was released.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34">[34]</a></sup> Along with the <a href="/wiki/New_York_Academy_of_Medicine" title="New York Academy of Medicine">New York Academy of Medicine</a>, the APA provided the psychiatric <a href="/wiki/Nomenclature" title="Nomenclature">nomenclature</a> subsection.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35">[35]</a></sup> It became well adopted in the US within two years.<sup id="cite_ref-:8_33-1" class="reference"><a href="#cite_note-:8-33">[33]</a></sup> A major revision of the Statistical Manual was made in 1934, to bring it in line with the new Standard.<sup id="cite_ref-:8_33-2" class="reference"><a href="#cite_note-:8-33">[33]</a></sup> A number of revisions of the Standard were produced, with the last in 1961.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36">[36]</a></sup>
</p>
<h3><span id="Medical_203_.281945.29"></span><span class="mw-headline" id="Medical_203_(1945)">Medical 203 (1945)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=5" title="Edit section: Medical 203 (1945)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p><a href="/wiki/World_War_II" title="World War II">World War II</a> saw the large-scale involvement of U.S. psychiatrists in the selection, processing, assessment, and treatment of soldiers.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37">[37]</a></sup> This moved the focus away from mental institutions and traditional clinical perspectives. The U.S. armed forces initially used the Standard, but found it lacked appropriate categories for many common conditions that troubled troops. The <a href="/wiki/US_Navy" class="mw-redirect" title="US Navy">United States Navy</a> made some minor revisions but "the Army established a much more sweeping revision, abandoning the basic outline of the Standard and attempting to express present-day concepts of mental disturbance."<sup id="cite_ref-:8_33-3" class="reference"><a href="#cite_note-:8-33">[33]</a></sup>
</p><p>Under the direction of <a href="/wiki/James_Forrestal" title="James Forrestal">James Forrestal</a>,<sup id="cite_ref-NavyPsyc2_38-0" class="reference"><a href="#cite_note-NavyPsyc2-38">[38]</a></sup> a committee headed by psychiatrist <a href="/wiki/Brigadier_General_(United_States)" class="mw-redirect" title="Brigadier General (United States)">Brigadier General</a> <a href="/wiki/William_C._Menninger" title="William C. Menninger">William C. Menninger</a>, with the assistance of the Mental Hospital Service,<sup id="cite_ref-39" class="reference"><a href="#cite_note-39">[39]</a></sup> developed a new classification scheme in 1944 and 1945.
</p><p>Issued in War Department Technical Bulletin, Medical, 203 (TB MED 203); <i>Nomenclature and Method of Recording Diagnoses</i> was released shortly after the war in October 1945 under the auspices of the <a href="/wiki/Office_of_the_Surgeon_General" class="mw-redirect" title="Office of the Surgeon General">Office of the Surgeon General</a>.<sup id="cite_ref-Houts2000_40-0" class="reference"><a href="#cite_note-Houts2000-40">[40]</a></sup> It was reprinted in the <a href="/wiki/Journal_of_Clinical_Psychology" title="Journal of Clinical Psychology">Journal of Clinical Psychology</a> for civilian use in July 1946 with the new title <i>Nomenclature of Psychiatric Disorders and Reactions</i>.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41">[41]</a></sup> This system came to be known as "Medical 203".
</p><p>This nomenclature eventually was adopted by all the armed forces, and "assorted modifications of the Armed Forces nomenclature [were] introduced into many clinics and hospitals by psychiatrists returning from military duty."<sup id="cite_ref-:8_33-4" class="reference"><a href="#cite_note-:8-33">[33]</a></sup> The <a href="/wiki/United_States_Department_of_Veterans_Affairs" title="United States Department of Veterans Affairs">Veterans Administration</a> also adopted a slightly modified version of the standard in 1947.<sup id="cite_ref-NavyPsyc2_38-1" class="reference"><a href="#cite_note-NavyPsyc2-38">[38]</a></sup>
</p><p>The further developed <i>Joint Armed Forces Nomenclature and Method of Recording Psychiatric Conditions</i> was released in 1949.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42">[42]</a></sup>
</p>
<h3><span id="ICD-6_.281948.29"></span><span class="mw-headline" id="ICD-6_(1948)">ICD-6 (1948)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=6" title="Edit section: ICD-6 (1948)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>In 1948, the newly formed <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> took over the maintenance of the ILCD. They greatly expanded it, included non-fatal conditions for the first time, and renamed it the <i><a href="/wiki/International_Statistical_Classification_of_Diseases" class="mw-redirect" title="International Statistical Classification of Diseases">International Statistical Classification of Diseases</a></i> (ICD). The foreword to the DSM-I states the ICD-6 "categorized mental disorders in rubrics similar to those of the Armed Forces nomenclature."<sup id="cite_ref-:8_33-5" class="reference"><a href="#cite_note-:8-33">[33]</a></sup>
</p>
<h2><span id="Early_versions_.2820th_century.29"></span><span class="mw-headline" id="Early_versions_(20th_century)">Early versions (20th century)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=7" title="Edit section: Early versions (20th century)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<h3><span id="DSM-I_.281952.29"></span><span class="mw-headline" id="DSM-I_(1952)">DSM-I (1952)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=8" title="Edit section: DSM-I (1952)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>The APA Committee on Nomenclature and Statistics was empowered to develop a version of Medical 203 specifically for use in the United States, to standardize the diverse and confused usage of different documents. In 1950, the APA committee undertook a review and consultation. It circulated an adaptation of Medical 203, the <i>Standard</i><span class="nowrap" style="padding-left:0.1em;">'</span>s nomenclature, and the VA system's modifications of the <i>Standard</i> to approximately 10% of APA members. 46% of members replied, with 93% approving the changes. After some further revisions, the <i>Diagnostic and Statistical Manual of Mental Disorders</i> was approved in 1951 and published in 1952. The structure and conceptual framework were the same as in Medical 203, and many passages of text were identical.<sup id="cite_ref-Houts2000_40-1" class="reference"><a href="#cite_note-Houts2000-40">[40]</a></sup> The manual was 130 pages long and listed 106 mental disorders.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43">[43]</a></sup> These included several categories of "personality disturbance", generally distinguished from "neurosis" (nervousness, <a href="/wiki/Egodystonic" class="mw-redirect" title="Egodystonic">egodystonic</a>).<sup id="cite_ref-Oldham_44-0" class="reference"><a href="#cite_note-Oldham-44">[44]</a></sup>
</p><p>The foreword to this edition describes itself as being a continuation of the <i>Statistical Manual for the Use of Hospitals of Mental Diseases.<sup id="cite_ref-:8_33-6" class="reference"><a href="#cite_note-:8-33">[33]</a></sup></i> Each item was given an ICD-6 equivalent code, where applicable.
</p>
<figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Statistical_card_for_use_in_hospitals_for_mental_illness.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Statistical_card_for_use_in_hospitals_for_mental_illness.jpg/220px-Statistical_card_for_use_in_hospitals_for_mental_illness.jpg" decoding="async" width="220" height="238" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Statistical_card_for_use_in_hospitals_for_mental_illness.jpg/330px-Statistical_card_for_use_in_hospitals_for_mental_illness.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Statistical_card_for_use_in_hospitals_for_mental_illness.jpg/440px-Statistical_card_for_use_in_hospitals_for_mental_illness.jpg 2x" data-file-width="2729" data-file-height="2950" /></a><figcaption></figcaption></figure>
<p>The DSM-I centers around three classes of symptoms: psychotic, neurotic, and behavioral.<sup id="cite_ref-:9_45-0" class="reference"><a href="#cite_note-:9-45">[45]</a></sup>  Within each class of mental disorder, classifying information is provided to differentiate conditions with similar symptoms.  Under each broad class of disorder (e.g. "Psychoneurotic Disorders" or "Personality Disorders"), all possible diagnoses are listed, generally from least to most severe.<sup id="cite_ref-:9_45-1" class="reference"><a href="#cite_note-:9-45">[45]</a></sup> The 1952 DSM version also includes sections detailing how to record patients' disorders along with their demographic details.<sup id="cite_ref-:9_45-2" class="reference"><a href="#cite_note-:9-45">[45]</a></sup>  The form includes information like a patient's area of residence, admission status, discharge date/condition, and severity of disorder.<sup id="cite_ref-:9_45-3" class="reference"><a href="#cite_note-:9-45">[45]</a></sup> See Figure 1. for the form that psychiatrists were asked to utilize for recording preliminary diagnostic information.<sup id="cite_ref-:9_45-4" class="reference"><a href="#cite_note-:9-45">[45]</a></sup>
</p><p>Furthermore, the APA listed homosexuality in the DSM as a <a href="/wiki/Antisocial_personality_disorder" title="Antisocial personality disorder">sociopathic</a> personality disturbance. <i><a href="/w/index.php?title=Homosexuality:_A_Psychoanalytic_Study_of_Male_Homosexuals&action=edit&redlink=1" class="new" title="Homosexuality: A Psychoanalytic Study of Male Homosexuals (page does not exist)">Homosexuality: A Psychoanalytic Study of Male Homosexuals</a></i>, a large-scale 1962 study of homosexuality by <a href="/wiki/Irving_Bieber" title="Irving Bieber">Irving Bieber</a> and other authors, was used to justify inclusion of the disorder as a supposed pathological hidden fear of the opposite sex caused by traumatic parent–child relationships. This view was influential in the medical profession.<sup id="cite_ref-:0_46-0" class="reference"><a href="#cite_note-:0-46">[46]</a></sup> In 1956, however, the psychologist <a href="/wiki/Evelyn_Hooker" title="Evelyn Hooker">Evelyn Hooker</a> performed a study comparing the happiness and well-adjusted nature of self-identified homosexual men with heterosexual men and found no difference.<sup id="cite_ref-:0_46-1" class="reference"><a href="#cite_note-:0-46">[46]</a></sup> Her study stunned the medical community and made her a heroine to many gay men and lesbians,<sup id="cite_ref-47" class="reference"><a href="#cite_note-47">[47]</a></sup> but homosexuality remained in the DSM until May 1974.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48">[48]</a></sup>
</p>
<h3><span id="DSM-II_.281968.29"></span><span class="mw-headline" id="DSM-II_(1968)">DSM-II (1968)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=9" title="Edit section: DSM-II (1968)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>In the 1960s, there were many challenges to the concept of <a href="/wiki/Mental_illness" class="mw-redirect" title="Mental illness">mental illness</a> itself. These challenges came from psychiatrists like <a href="/wiki/Thomas_Szasz" title="Thomas Szasz">Thomas Szasz</a>, who argued mental illness was a myth used to disguise moral conflicts; from sociologists such as <a href="/wiki/Erving_Goffman" title="Erving Goffman">Erving Goffman</a>, who said mental illness was another example of how society labels and controls non-conformists; from <a href="/wiki/Behavioural_psychologist" class="mw-redirect" title="Behavioural psychologist">behavioural psychologists</a> who challenged psychiatry's fundamental reliance on unobservable phenomena; and from gay rights activists who criticised the APA's listing of homosexuality as a mental disorder.
</p><p>The APA was closely involved in the next significant revision of the mental disorder section of the ICD (version 8 in 1968). It decided to go ahead with a revision of the DSM, which was published in 1968. DSM-II was similar to DSM-I, listed 182 disorders, and was 134 pages long. The term "reaction" was dropped, but the term "<a href="/wiki/Neurosis" title="Neurosis">neurosis</a>" was retained. Both the DSM-I and the DSM-II reflected the predominant <a href="/wiki/Psychodynamic" class="mw-redirect" title="Psychodynamic">psychodynamic</a> psychiatry,<sup id="cite_ref-Revolution_49-0" class="reference"><a href="#cite_note-Revolution-49">[49]</a></sup> although both manuals also included biological perspectives and concepts from <a href="/wiki/Emil_Kraepelin" title="Emil Kraepelin">Kraepelin</a>'s system of classification. Symptoms were not specified in detail for specific disorders. Many were seen as reflections of broad underlying conflicts or maladaptive reactions to life problems that were rooted in a distinction between neurosis and <a href="/wiki/Psychosis" title="Psychosis">psychosis</a> (roughly, anxiety/depression broadly in touch with reality, as opposed to <a href="/wiki/Hallucinations" class="mw-redirect" title="Hallucinations">hallucinations</a> or <a href="/wiki/Delusions" class="mw-redirect" title="Delusions">delusions</a> disconnected from reality). Sociological and biological knowledge was incorporated, under a model that did not emphasize a clear boundary between normality and abnormality.<sup id="cite_ref-Transformation_50-0" class="reference"><a href="#cite_note-Transformation-50">[50]</a></sup> The idea that personality disorders did not involve emotional distress was discarded.<sup id="cite_ref-Oldham_44-1" class="reference"><a href="#cite_note-Oldham-44">[44]</a></sup>
</p><p>A study published in <i>Science</i> in 1973, the <a href="/wiki/Rosenhan_experiment" title="Rosenhan experiment">Rosenhan experiment</a>, received much publicity and was viewed as an attack on the efficacy of psychiatric diagnosis.<sup id="cite_ref-Stuart_A,_Kirk_&_Herb_Kutchins_1994_51-0" class="reference"><a href="#cite_note-Stuart_A,_Kirk_&_Herb_Kutchins_1994-51">[51]</a></sup>
An influential 1974 paper by <a href="/wiki/Robert_Spitzer_(psychiatrist)" title="Robert Spitzer (psychiatrist)">Robert Spitzer</a> and <a href="/wiki/Joseph_L._Fleiss" title="Joseph L. Fleiss">Joseph L. Fleiss</a> demonstrated that the second edition of the DSM (DSM-II) was an unreliable diagnostic tool.<sup id="cite_ref-SpitzerFleiss1974_52-0" class="reference"><a href="#cite_note-SpitzerFleiss1974-52">[52]</a></sup> Spitzer and Fleiss found that different practitioners using the DSM-II rarely agreed when diagnosing patients with similar problems. In reviewing previous studies of eighteen major diagnostic categories, Spitzer and Fleiss concluded that "there are no diagnostic categories for which reliability is uniformly high. Reliability appears to be only satisfactory for three categories: mental deficiency, organic brain syndrome (but not its subtypes), and alcoholism. The level of reliability is no better than fair for psychosis and <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a> and is poor for the remaining categories".<sup id="cite_ref-Kirk_&_Kutchins_53-0" class="reference"><a href="#cite_note-Kirk_&_Kutchins-53">[53]</a></sup>
</p>
<h4><span id="Seventh_printing_of_the_DSM-II_.281974.29"></span><span class="mw-headline" id="Seventh_printing_of_the_DSM-II_(1974)">Seventh printing of the DSM-II (1974)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=10" title="Edit section: Seventh printing of the DSM-II (1974)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<p>As described by Ronald Bayer, a psychiatrist and gay rights activist, specific protests by <a href="/wiki/Gay_rights" class="mw-redirect" title="Gay rights">gay rights</a> activists against the APA began in 1970, when the organization held its convention in <a href="/wiki/San_Francisco" title="San Francisco">San Francisco</a>. The activists disrupted the conference by interrupting speakers and shouting down and ridiculing psychiatrists who viewed homosexuality as a mental disorder. In 1971, gay rights activist <a href="/wiki/Frank_Kameny" title="Frank Kameny">Frank Kameny</a> worked with the <a href="/wiki/Gay_Liberation_Front" title="Gay Liberation Front">Gay Liberation Front</a> collective to demonstrate at the APA's convention. At the 1971 conference, Kameny grabbed the microphone and yelled: "Psychiatry is the enemy incarnate. Psychiatry has waged a relentless war of extermination against us. You may take this as a declaration of war against you."<sup id="cite_ref-54" class="reference"><a href="#cite_note-54">[54]</a></sup>
</p><p>This gay activism occurred in the context of a broader <a href="/wiki/Anti-psychiatry" title="Anti-psychiatry">anti-psychiatry</a> movement that had come to the fore in the 1960s and was challenging the legitimacy of psychiatric diagnosis. Anti-psychiatry activists protested at the same APA conventions, with some shared slogans and intellectual foundations as gay activists.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55">[55]</a></sup><sup id="cite_ref-56" class="reference"><a href="#cite_note-56">[56]</a></sup>
</p><p>Taking into account data from researchers such as <a href="/wiki/Alfred_Kinsey" title="Alfred Kinsey">Alfred Kinsey</a> and <a href="/wiki/Evelyn_Hooker" title="Evelyn Hooker">Evelyn Hooker</a>, the seventh printing of the DSM-II, in 1974, no longer listed homosexuality as a category of disorder.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57">[a]</a></sup> After a vote by the APA trustees in 1973, and confirmed by the wider APA membership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance".<sup id="cite_ref-58" class="reference"><a href="#cite_note-58">[57]</a></sup><sup id="cite_ref-59" class="reference"><a href="#cite_note-59">[58]</a></sup>
</p>
<h3><span id="DSM-III_.281980.29"></span><span class="mw-headline" id="DSM-III_(1980)">DSM-III (1980)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=11" title="Edit section: DSM-III (1980)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>The emergence of DSM III represented a "quantum leap" in terms of the scale and reach of the manual.<sup id="cite_ref-Coolidge_and_Segal_1998_60-0" class="reference"><a href="#cite_note-Coolidge_and_Segal_1998-60">[59]</a></sup> In 1974, the decision to revise the DSM was made, and psychiatrist <a href="/wiki/Robert_Spitzer_(psychiatrist)" title="Robert Spitzer (psychiatrist)">Robert Spitzer</a> was selected as chair of the task force. The initial impetus was to make the DSM nomenclature consistent with that of the <a href="/wiki/International_Classification_of_Diseases" title="International Classification of Diseases">International Classification of Diseases</a> (ICD). The revision took on a far wider mandate under the influence and control of Spitzer and his chosen committee members.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61">[60]</a></sup> One added goal was to improve the uniformity and validity of psychiatric diagnosis in the wake of a number of critiques, including the famous <a href="/wiki/Rosenhan_experiment" title="Rosenhan experiment">Rosenhan experiment</a>. There was also felt a need to standardize diagnostic practices within the United States and with other countries, after research showed that psychiatric diagnoses differed between Europe and the United States.<sup id="cite_ref-PMID5774702_62-0" class="reference"><a href="#cite_note-PMID5774702-62">[61]</a></sup> The establishment of consistent criteria was an attempt to facilitate the pharmaceutical regulatory process.
</p><p>The criteria adopted for many of the mental disorders were influenced by the <a href="/wiki/Research_Diagnostic_Criteria" title="Research Diagnostic Criteria">Research Diagnostic Criteria</a> (RDC) and <a href="/wiki/Feighner_Criteria" title="Feighner Criteria">Feighner Criteria</a>, which had just been developed by a group of research-orientated psychiatrists based primarily at <a href="/wiki/Washington_University_School_of_Medicine" title="Washington University School of Medicine">Washington University School of Medicine</a> and the <a href="/wiki/New_York_State_Psychiatric_Institute" title="New York State Psychiatric Institute">New York State Psychiatric Institute</a>. However, the influence of clinical psychiatrists, themselves often working with psychoanalytic ideas were still strong.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63">[62]</a></sup> Other criteria, and potential new categories of disorder, were established by debate, argument and consensus during meetings of the committee chaired by Spitzer. A key aim was to base categorization on colloquial English (which would be easier to use by federal administrative offices), rather than by assumption of cause, although its categorical approach still assumed each particular pattern of symptoms in a category reflected a particular underlying pathology (an approach described as "<a href="/wiki/Emil_Kraepelin" title="Emil Kraepelin">neo-Kraepelinian</a>"). The <a href="/wiki/Psychodynamic" class="mw-redirect" title="Psychodynamic">psychodynamic</a> view was marginalised, although still influential, in favor of a <a href="/wiki/Regulatory" class="mw-redirect" title="Regulatory">regulatory</a> or <a href="/wiki/Legislative" class="mw-redirect" title="Legislative">legislative</a> model that emphasised observable symptoms.<sup id="cite_ref-Decker_(2013)_64-0" class="reference"><a href="#cite_note-Decker_(2013)-64">[63]</a></sup> A new "multiaxial" system attempted to yield a picture more amenable to a statistical population census, rather than a simple <a href="/wiki/Medical_diagnosis" title="Medical diagnosis">diagnosis</a>. Spitzer argued "mental disorders are a subset of medical disorders", but the task force decided on this statement for the DSM: "Each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome."<sup id="cite_ref-Revolution_49-1" class="reference"><a href="#cite_note-Revolution-49">[49]</a></sup> <a href="/wiki/Personality_disorders" class="mw-redirect" title="Personality disorders">Personality disorders</a> were placed on axis II along with "mental retardation".<sup id="cite_ref-Oldham_44-2" class="reference"><a href="#cite_note-Oldham-44">[44]</a></sup>
</p><p>The first draft of DSM-III was ready within a year. It introduced many new categories of disorder, while deleting or changing others. A number of unpublished documents discussing and justifying the changes have recently come to light.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65">[64]</a></sup> Field trials sponsored by the U.S. <a href="/wiki/National_Institute_of_Mental_Health" title="National Institute of Mental Health">National Institute of Mental Health</a> (NIMH) were conducted between 1977 and 1979 to test the reliability of the new diagnoses. A controversy emerged regarding deletion of the concept of neurosis, a mainstream of <a href="/wiki/Psychoanalytic" class="mw-redirect" title="Psychoanalytic">psychoanalytic</a> theory and therapy but seen as vague and unscientific by the DSM task force. Faced with enormous political opposition, DSM-III was in serious danger of not being approved by the APA Board of Trustees unless "neurosis" was included in some form; a political compromise reinserted the term in parentheses after the word "disorder" in some cases. Additionally, the diagnosis of <a href="/wiki/Ego-dystonic_sexual_orientation" title="Ego-dystonic sexual orientation">ego-dystonic homosexuality</a> replaced the DSM-II category of "sexual orientation disturbance". The <a href="/wiki/Gender_dysphoria_in_children" title="Gender dysphoria in children">gender identity disorder in children</a> (GIDC) diagnosis was introduced in the DSM-III; prior to the DSM-III's publication in 1980, there was no diagnostic criteria for <a href="/wiki/Gender_dysphoria" title="Gender dysphoria">gender dysphoria</a>.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66">[65]</a></sup><sup id="cite_ref-Need_67-0" class="reference"><a href="#cite_note-Need-67">[66]</a></sup>
</p><p>Finally published in 1980, DSM-III listed 265 diagnostic categories and was 494 pages long. It rapidly came into widespread international use and has been termed a revolution, or transformation, in psychiatry.<sup id="cite_ref-Revolution_49-2" class="reference"><a href="#cite_note-Revolution-49">[49]</a></sup><sup id="cite_ref-Transformation_50-1" class="reference"><a href="#cite_note-Transformation-50">[50]</a></sup>
</p><p>When DSM-III was published, the developers made extensive claims about the reliability of the radically new diagnostic system they had devised, which relied on data from special field trials. However, according to a 1994 article by <a href="/wiki/Stuart_A._Kirk" title="Stuart A. Kirk">Stuart A. Kirk</a>:
</p>
<style data-mw-deduplicate="TemplateStyles:r1211633275">.mw-parser-output .templatequote{overflow:hidden;margin:1em 0;padding:0 32px}.mw-parser-output .templatequote .templatequotecite{line-height:1.5em;text-align:left;padding-left:1.6em;margin-top:0}</style><blockquote class="templatequote"><p>Twenty years after the reliability problem became the central focus of DSM-III, there is still not a single multi-site study showing that DSM (any version) is routinely used with high reliably by regular mental health clinicians. Nor is there any credible evidence that any version of the manual has greatly increased its reliability beyond the previous version. There are important methodological problems that limit the generalizability of most reliability studies. Each reliability study is constrained by the training and supervision of the interviewers, their motivation and commitment to diagnostic accuracy, their prior skill, the homogeneity of the clinical setting in regard to patient mix and base rates, and the methodological rigor achieved by the investigator ...<sup id="cite_ref-Stuart_A,_Kirk_&_Herb_Kutchins_1994_51-1" class="reference"><a href="#cite_note-Stuart_A,_Kirk_&_Herb_Kutchins_1994-51">[51]</a></sup></p></blockquote>
<h3><span id="DSM-III-R_.281987.29"></span><span class="mw-headline" id="DSM-III-R_(1987)">DSM-III-R (1987)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=12" title="Edit section: DSM-III-R (1987)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>In 1987, DSM-III-R was published as a revision of the DSM-III, under the direction of Spitzer. Categories were renamed and reorganized, with significant changes in criteria. Six categories were deleted while others were added. Controversial diagnoses, such as <a href="/wiki/Premenstrual_dysphoric_disorder" title="Premenstrual dysphoric disorder">Premenstrual Dysphoric Disorder</a> and <a href="/wiki/Self-defeating_personality_disorder" title="Self-defeating personality disorder">Masochistic Personality Disorder</a>, were considered and discarded. (Premenstrual Dysphoric Disorder was later reincorporated in the DSM-5, published in 2013).<sup id="cite_ref-68" class="reference"><a href="#cite_note-68">[67]</a></sup> "Ego-dystonic homosexuality" was also removed and was largely subsumed under "sexual disorder not otherwise specified", which could include "persistent and marked distress about one's sexual orientation."<sup id="cite_ref-Revolution_49-3" class="reference"><a href="#cite_note-Revolution-49">[49]</a></sup><sup id="cite_ref-69" class="reference"><a href="#cite_note-69">[68]</a></sup> Altogether, the DSM-III-R contained 292 diagnoses and was 567 pages long. Further efforts were made for the diagnoses to be purely descriptive, although the introductory text stated for at least some disorders, "particularly the Personality Disorders, the criteria require much more inference on the part of the observer"[page xxiii].<sup id="cite_ref-Oldham_44-3" class="reference"><a href="#cite_note-Oldham-44">[44]</a></sup>
</p>
<h3><span id="DSM-IV_.281994.29"></span><span class="mw-headline" id="DSM-IV_(1994)">DSM-IV (1994)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=13" title="Edit section: DSM-IV (1994)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>In 1994, DSM-IV was published, listing 410 disorders in 886 pages. The task force was chaired by <a href="/wiki/Allen_Frances" title="Allen Frances">Allen Frances</a> and was overseen by a steering committee of twenty-seven people, including four psychologists. The steering committee created thirteen work groups of five to sixteen members, each work group having about twenty advisers in addition. The work groups conducted a three-step process: first, each group conducted an extensive literature review of their diagnoses; then, they requested data from researchers, conducting analyses to determine which criteria required change, with instructions to be conservative; finally, they conducted multi-center field trials relating diagnoses to clinical practice.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70">[69]</a></sup><sup id="cite_ref-71" class="reference"><a href="#cite_note-71">[70]</a></sup> A major change from previous versions was the inclusion of a clinical-significance criterion to almost half of all the categories, which required symptoms causing "clinically significant distress or impairment in social, occupational, or other important areas of functioning". Some personality-disorder diagnoses were deleted or moved to the appendix.<sup id="cite_ref-Oldham_44-4" class="reference"><a href="#cite_note-Oldham-44">[44]</a></sup>
</p>
<h4><span class="mw-headline" id="DSM-IV_Definitions">DSM-IV Definitions</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=14" title="Edit section: DSM-IV Definitions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<style data-mw-deduplicate="TemplateStyles:r1033289096">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/DSM-IV_codes" class="mw-redirect" title="DSM-IV codes">DSM-IV codes</a></div>
<p>The DSM-IV characterizes a mental disorder as "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significant increased risk of suffering death, pain, disability, or an important loss of freedom".<sup id="cite_ref-72" class="reference"><a href="#cite_note-72">[71]</a></sup> It also notes that "although this manual provides a classification of mental disorders it must be admitted that no definition adequately specifies precise boundaries for the concept of 'mental disorder."<sup id="cite_ref-pmid20624327_73-0" class="reference"><a href="#cite_note-pmid20624327-73">[72]</a></sup>
</p>
<h4><span class="mw-headline" id="DSM-IV_Categorization">DSM-IV Categorization</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=15" title="Edit section: DSM-IV Categorization"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<p>The DSM-IV is a categorical classification system. The categories are sigma, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade, and non-criterion (unlisted for a given disorder) symptoms are not given importance.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74">[73]</a></sup> Qualifiers are sometimes used: for example, to specify mild, moderate, or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from <a href="/wiki/Tic_disorder" title="Tic disorder">tic disorders</a> and several of the <a href="/wiki/Paraphilia" title="Paraphilia">paraphilias</a> due to their <a href="/wiki/Egosyntonic" class="mw-redirect" title="Egosyntonic">egosyntonic</a> nature. Each category of disorder has a numeric code taken from the <a href="/wiki/ICD_coding_system" class="mw-redirect" title="ICD coding system">ICD coding system</a>, used for health service (including insurance) administrative purposes.
</p>
<h4><span class="mw-headline" id="DSM-IV_multi-axial_system"><span class="anchor" id="DSM-IV-TR_multi-axial_system"></span>DSM-IV multi-axial system</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=16" title="Edit section: DSM-IV multi-axial system"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<p>The DSM-IV was organized into a five-part axial system. Axis I provided information about clinical disorders, or any mental condition other than personality disorders and what was referred to in DSM editions prior to DSM-V as "mental retardation". Those were both covered on Axis II. Axis III covered medical conditions that could impact a person's disorder or treatment of a disorder and Axis IV covered psychosocial and environmental factors affecting the person. Axis V was the GAF, or global assessment of functioning, which was basically a numerical score between 0 and 100 that measured how much a person's psychological symptoms impacted their daily life.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75">[74]</a></sup>
</p>
<h4><span class="mw-headline" id="DSM-IV_Sourcebooks">DSM-IV Sourcebooks</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=17" title="Edit section: DSM-IV Sourcebooks"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<p>The DSM-IV does not specifically cite its sources, but there are four volumes of "sourcebooks" intended to be APA's documentation of the guideline development process and supporting evidence, including literature reviews, data analyses, and field trials.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76">[75]</a></sup><sup id="cite_ref-77" class="reference"><a href="#cite_note-77">[76]</a></sup><sup id="cite_ref-78" class="reference"><a href="#cite_note-78">[77]</a></sup><sup id="cite_ref-79" class="reference"><a href="#cite_note-79">[78]</a></sup> The sourcebooks have been said to provide important insights into the character and quality of the decisions that led to the production of DSM-IV, and the scientific credibility of contemporary psychiatric classification.<sup id="cite_ref-Poland01vol1_80-0" class="reference"><a href="#cite_note-Poland01vol1-80">[79]</a></sup><sup id="cite_ref-Poland01vol2_81-0" class="reference"><a href="#cite_note-Poland01vol2-81">[80]</a></sup>
</p>
<h3><span id="DSM-IV-TR_.282000.29"></span><span class="mw-headline" id="DSM-IV-TR_(2000)">DSM-IV-TR (2000)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=18" title="Edit section: DSM-IV-TR (2000)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>A text revision of DSM-IV, titled DSM-IV-TR, was published in 2000. The diagnostic categories were unchanged as were the diagnostic criteria for all but nine diagnoses.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82">[81]</a></sup> The majority of the text was unchanged; however, the text of two disorders, pervasive developmental disorder not otherwise specified and Asperger's disorder, had significant and/or multiple changes made. The definition of pervasive developmental disorder not otherwise specified was changed back to what it was in DSM-III-R and the text for Asperger's disorder was practically entirely rewritten. Most other changes were to the associated features sections of diagnoses that contained additional information such as lab findings, demographic information, prevalence, and course. Also, some diagnostic codes were changed to maintain consistency with ICD-9-CM.<sup id="cite_ref-pmid11875221_83-0" class="reference"><a href="#cite_note-pmid11875221-83">[82]</a></sup>
</p>
<h2><span id="DSM-5_.282013.29"></span><span class="mw-headline" id="DSM-5_(2013)">DSM-5 (2013)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=19" title="Edit section: DSM-5 (2013)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1033289096"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/DSM-5" title="DSM-5">DSM-5</a></div>
<p>The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5, was approved by the Board of Trustees of the APA on December 1, 2012.<sup id="cite_ref-84" class="reference"><a href="#cite_note-84">[83]</a></sup> Published on May 18, 2013,<sup id="cite_ref-85" class="reference"><a href="#cite_note-85">[84]</a></sup> the DSM-5 contains extensively revised diagnoses and, in some cases, broadens diagnostic definitions while narrowing definitions in other cases.<sup id="cite_ref-86" class="reference"><a href="#cite_note-86">[85]</a></sup> The DSM-5 is the first major edition of the manual in 20 years.<sup id="cite_ref-87" class="reference"><a href="#cite_note-87">[86]</a></sup> DSM-5, and the abbreviations for all previous editions, are <a href="/wiki/Trademark#Registration" title="Trademark">registered trademarks</a> owned by the American Psychiatric Association.<sup id="cite_ref-concept&evolution_9-1" class="reference"><a href="#cite_note-concept&evolution-9">[9]</a></sup><sup id="cite_ref-titleTrademark'''_Electronic_Search_System_(TESS)_88-0" class="reference"><a href="#cite_note-titleTrademark'''_Electronic_Search_System_(TESS)-88">[87]</a></sup>
</p><p>A significant change in the fifth edition is the deletion of the subtypes of <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>: <a href="/wiki/Paranoid_schizophrenia" class="mw-redirect" title="Paranoid schizophrenia">paranoid</a>, <a href="/wiki/Disorganized_schizophrenia" title="Disorganized schizophrenia">disorganized</a>, <a href="/wiki/Catatonic_schizophrenia" class="mw-redirect" title="Catatonic schizophrenia">catatonic</a>, <a href="/wiki/Undifferentiated_schizophrenia" class="mw-redirect" title="Undifferentiated schizophrenia">undifferentiated</a>, and <a href="/wiki/Residual_schizophrenia" class="mw-redirect" title="Residual schizophrenia">residual</a>.<sup id="cite_ref-89" class="reference"><a href="#cite_note-89">[88]</a></sup> The deletion of the subsets of <a href="/wiki/Autism_spectrum" title="Autism spectrum">autistic spectrum disorder</a> – namely, <a href="/wiki/Asperger%27s_syndrome" class="mw-redirect" title="Asperger's syndrome">Asperger's syndrome</a>, <a href="/wiki/Classic_autism" title="Classic autism">classic autism</a>, <a href="/wiki/Rett_syndrome" title="Rett syndrome">Rett syndrome</a>, <a href="/wiki/Childhood_disintegrative_disorder" title="Childhood disintegrative disorder">childhood disintegrative disorder</a> and <a href="/wiki/Pervasive_developmental_disorder_not_otherwise_specified" title="Pervasive developmental disorder not otherwise specified">pervasive developmental disorder not otherwise specified</a> – was also implemented, with specifiers regarding intensity: mild, moderate, and severe.
</p><p>Severity is based on social communication impairments and restricted, repetitive patterns of behavior, with three levels:
</p>
<ol><li>requiring support</li>
<li>requiring substantial support</li>
<li>requiring very substantial support</li></ol>
<p>During the revision process, the APA website periodically listed several sections of the DSM-5 for review and discussion.<sup id="cite_ref-90" class="reference"><a href="#cite_note-90">[89]</a></sup>
</p>
<h3><span class="mw-headline" id="Future_revisions_and_updates">Future revisions and updates</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=20" title="Edit section: Future revisions and updates"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>Beginning with the fifth edition, the APA communicated that they intend to add subsequent revisions more often, to keep up with research in the field.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91">[90]</a></sup> It is notable that DSM-5 uses <a href="/wiki/Arabic_numerals" title="Arabic numerals">Arabic</a> rather than <a href="/wiki/Roman_numerals" title="Roman numerals">Roman numerals</a>. Beginning with DSM-5, the APA will use decimals to identify incremental updates (e.g., DSM-5.1, DSM-5.2)<sup id="cite_ref-92" class="reference"><a href="#cite_note-92">[b]</a></sup> and whole numbers for new editions (e.g., DSM-5, DSM-6),<sup id="cite_ref-93" class="reference"><a href="#cite_note-93">[91]</a></sup> similar to the scheme used for <a href="/wiki/Software_versioning" title="Software versioning">software versioning</a>.
</p><p>The National Board of Medical Examiners (NBME), which is responsible for creating and publishing board exams for medical students around the United States, conforms to the use of DSM-5 criteria.<sup id="cite_ref-94" class="reference"><a href="#cite_note-94">[92]</a></sup>
</p>
<h3><span id="DSM-5-TR_.282022.29"></span><span class="mw-headline" id="DSM-5-TR_(2022)">DSM-5-TR (2022)</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=21" title="Edit section: DSM-5-TR (2022)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>A revision of DSM-5, titled DSM-5-TR, was published in March 2022, updating diagnostic criteria and <a href="/wiki/ICD-10-CM" title="ICD-10-CM">ICD-10-CM</a> codes.<sup id="cite_ref-:3_95-0" class="reference"><a href="#cite_note-:3-95">[93]</a></sup> The diagnostic criteria for <a href="/wiki/Avoidant/restrictive_food_intake_disorder" title="Avoidant/restrictive food intake disorder">avoidant/restrictive food intake disorder</a> was changed,<sup id="cite_ref-:5_96-0" class="reference"><a href="#cite_note-:5-96">[94]</a></sup> along with adding entries for <a href="/wiki/Prolonged_grief_disorder" title="Prolonged grief disorder">prolonged grief disorder</a>, <a href="/w/index.php?title=Unspecified_Mood_Disorder&action=edit&redlink=1" class="new" title="Unspecified Mood Disorder (page does not exist)">unspecified mood disorder</a> and <a href="/w/index.php?title=Stimulant-Induced_Mild_Neurocognitive_Disorder&action=edit&redlink=1" class="new" title="Stimulant-Induced Mild Neurocognitive Disorder (page does not exist)">stimulant-induced mild neurocognitive disorder</a>.<sup id="cite_ref-:6_97-0" class="reference"><a href="#cite_note-:6-97">[95]</a></sup><sup id="cite_ref-98" class="reference"><a href="#cite_note-98">[96]</a></sup> Prolonged grief disorder, which had been present in the ICD-11, had criteria agreed upon by consensus in a one day in-person workshop sponsored by the APA.<sup id="cite_ref-:5_96-1" class="reference"><a href="#cite_note-:5-96">[94]</a></sup> A 2022 study found that higher rates of diagnosis of prolonged grief disorder in the ICD-11 could be explained by the DSM-5-TR criteria requiring symptoms persist for 12 months, and the ICD-11 requiring only 6 months.<sup id="cite_ref-99" class="reference"><a href="#cite_note-99">[97]</a></sup>
</p><p>Three review groups for sex and gender, culture and suicide, along with an "ethnoracial equity and inclusion work group" were involved in the creation of the DSM-5-TR which led to additional sections for each mental disorder discussing sex and gender, racial and cultural variations, and adding diagnostic codes for specifying levels of suicidality and nonsuicidal self-injury for mental disorders.<sup id="cite_ref-:6_97-1" class="reference"><a href="#cite_note-:6-97">[95]</a></sup><sup id="cite_ref-:5_96-2" class="reference"><a href="#cite_note-:5-96">[94]</a></sup>
</p><p>Other changed mental disorders included:<sup id="cite_ref-:4_100-0" class="reference"><a href="#cite_note-:4-100">[98]</a></sup>
</p>
<ul><li><a href="/wiki/Autism_spectrum" title="Autism spectrum">Autism spectrum disorder</a></li>
<li><a href="/wiki/Bipolar_I_disorder" title="Bipolar I disorder">Bipolar I disorder</a>, <a href="/wiki/Bipolar_II_disorder" title="Bipolar II disorder">Bipolar II disorder</a>, and related <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorders</a></li>
<li><a href="/wiki/Obsessive%E2%80%93compulsive_personality_disorder" title="Obsessive–compulsive personality disorder">Obsessive–compulsive personality disorder</a> in the <a href="/w/index.php?title=Alternative_DSM-5_model_for_personality_disorders&action=edit&redlink=1" class="new" title="Alternative DSM-5 model for personality disorders (page does not exist)">alternative DSM-5 model for personality disorders</a></li>
<li><a href="/wiki/Major_depressive_episode" title="Major depressive episode">Depressive episodes</a> with short-duration <a href="/wiki/Hypomania" title="Hypomania">hypomania</a></li>
<li><a href="/wiki/Intellectual_disability" title="Intellectual disability">Intellectual developmental disorder</a></li>
<li><a href="/wiki/Delusional_disorder" title="Delusional disorder">Delusional disorder</a></li>
<li><a href="/wiki/Disruptive_mood_dysregulation_disorder" title="Disruptive mood dysregulation disorder">Disruptive mood dysregulation disorder</a></li>
<li><a href="/wiki/Brief_psychotic_disorder" title="Brief psychotic disorder">Brief psychotic disorder</a></li></ul>
<h2><span class="mw-headline" id="DSM_Library">DSM Library</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=22" title="Edit section: DSM Library"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p>The APA have supplemented the DSM with supporting works, collectively forming the "DSM Library."<sup id="cite_ref-:7_101-0" class="reference"><a href="#cite_note-:7-101">[99]</a></sup> As of 2022, the other books in the library are "DSM-5 Handbook of Differential Diagnosis", "DSM-5 Clinical Cases", "DSM-5 Handbook on the Cultural Formulation Interview" and "Guía De Consulta De Los Criterios Diagnósticos Del DSM-5".<sup id="cite_ref-:7_101-1" class="reference"><a href="#cite_note-:7-101">[99]</a></sup>
</p>
<h2><span class="mw-headline" id="Criticisms">Criticisms</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=23" title="Edit section: Criticisms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p>Many criticisms have been leveled against the DSM and its usefulness as a diagnostic manual.
</p>
<h3><span class="mw-headline" id="Reliability_and_validity">Reliability and validity</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=24" title="Edit section: Reliability and validity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>The revisions of the DSM from the 3rd Edition forward have been mainly concerned with <a href="/wiki/Inter-rater_reliability" title="Inter-rater reliability">diagnostic reliability</a> – the degree to which different diagnosticians agree on a diagnosis. Henrik Walter argued that psychiatry as a science can only advance if diagnosis is reliable. If clinicians and researchers frequently disagree about the diagnosis of a patient, then research into the causes and effective treatments of those disorders cannot advance. Hence, diagnostic reliability was a major concern of DSM-III. When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria. Neither the issue of reliability or validity was settled.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102">[100]</a></sup><sup id="cite_ref-103" class="reference"><a href="#cite_note-103">[101]</a></sup>
</p><p>In 2013, shortly before the publication of DSM-5, the director of the <a href="/wiki/National_Institute_of_Mental_Health" title="National Institute of Mental Health">National Institute of Mental Health</a> (NIMH), <a href="/wiki/Thomas_R._Insel" title="Thomas R. Insel">Thomas R. Insel</a>, declared that the agency would no longer fund research projects that relied exclusively on DSM diagnostic criteria, due to its lack of validity.<sup id="cite_ref-104" class="reference"><a href="#cite_note-104">[102]</a></sup> Insel questioned the validity of the DSM classification scheme because "diagnoses are based on a consensus about clusters of clinical symptoms" as opposed to "collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response."<sup id="cite_ref-105" class="reference"><a href="#cite_note-105">[103]</a></sup><sup id="cite_ref-106" class="reference"><a href="#cite_note-106">[104]</a></sup>
</p><p>Field trials of DSM-5 brought the debate of reliability back into the limelight, as the diagnoses of some disorders showed poor reliability. For example, a diagnosis of <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">major depressive disorder</a>, a common mental illness, had a poor reliability <a href="/wiki/Cohen%27s_kappa" title="Cohen's kappa">kappa</a> statistic of 0.28, indicating that clinicians frequently disagreed on diagnosing this disorder in the same patients. The most reliable diagnosis was major neurocognitive disorder, with a kappa of 0.78.<sup id="cite_ref-107" class="reference"><a href="#cite_note-107">[105]</a></sup>
</p>
<h3><span class="mw-headline" id="Diagnosis_based_on_superficial_symptoms">Diagnosis based on superficial symptoms</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=25" title="Edit section: Diagnosis based on superficial symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect these disorders based on statistical or clinical patterns. As such, it has been compared to a naturalist's field guide to birds, with similar advantages and disadvantages.<sup id="cite_ref-108" class="reference"><a href="#cite_note-108">[106]</a></sup> The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. Proponents argue this absence of explanatory classification is necessary, but it presents a problem for researchers as it results in the grouping of individuals who may have little in common except superficial criteria.<sup id="cite_ref-concept&evolution_9-2" class="reference"><a href="#cite_note-concept&evolution-9">[9]</a></sup><sup id="cite_ref-109" class="reference"><a href="#cite_note-109">[107]</a></sup> As <a href="/wiki/DSM-III" class="mw-redirect" title="DSM-III">DSM-III</a> chief architect <a href="/wiki/Robert_Spitzer_(psychiatrist)" title="Robert Spitzer (psychiatrist)">Robert Spitzer</a> and <a href="/wiki/DSM-IV" class="mw-redirect" title="DSM-IV">DSM-IV</a> editor Michael First outlined in 2005, "little progress has been made toward understanding the <a href="/wiki/Pathophysiology" title="Pathophysiology">pathophysiological</a> processes and cause of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."<sup id="cite_ref-110" class="reference"><a href="#cite_note-110">[108]</a></sup>
</p><p>While there is generally a lack of consensus on underlying causation for most psychiatric disorders, some proponents of specific <a href="/wiki/Psychopathology" title="Psychopathology">psychopathological</a> paradigms have faulted the DSM for failing to incorporate evidence from other disciplines. For instance, <a href="/wiki/Evolutionary_psychology" title="Evolutionary psychology">evolutionary psychology</a> distinguishes between genuine cognitive malfunctions and malfunctions due to psychological <a href="/wiki/Adaptations" class="mw-redirect" title="Adaptations">adaptations</a> (that is learned behaviors may be adaptive in one context but maladaptive in another). However, this distinction is one that is challenged within general psychology.<sup id="cite_ref-111" class="reference"><a href="#cite_note-111">[109]</a></sup><sup id="cite_ref-112" class="reference"><a href="#cite_note-112">[110]</a></sup><sup id="cite_ref-113" class="reference"><a href="#cite_note-113">[111]</a></sup>
</p><p>There is also criticism of the strong <a href="/wiki/Operationalization" title="Operationalization">operationalist</a> viewpoint of the DSM. The DSM relies on <a href="/wiki/Operational_definition" title="Operational definition">operational definitions</a>, which means that intuitive concepts like <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a> are defined by specific measurable criteria (observable behavior, specific timelines). Some have argued that instead of replacing metaphysical terms like "desire" or "purpose" the DSM chose to legitimize them by giving them operational definitions. However, this may have served only to provide a "reassurance fetish" for mainstream methodological practice, rather than representing a substantial and meaningful alteration of mainstream psychiatric practice.<sup id="cite_ref-114" class="reference"><a href="#cite_note-114">[112]</a></sup>
</p><p>A central problem with the use of superficial symptoms is that psychiatry deals with the <a href="/wiki/Phenomenology_(psychology)" title="Phenomenology (psychology)">phenomena</a> of <a href="/wiki/Consciousness" title="Consciousness">consciousness</a>, which adds much more complexity than the <a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">somatic</a> <a href="/wiki/Symptom" class="mw-redirect" title="Symptom">symptoms</a> and <a href="/wiki/Medical_sign" class="mw-redirect" title="Medical sign">signs</a> used by most of medicine. A 2013 review published in the <i><a href="/wiki/European_Archives_of_Psychiatry_and_Clinical_Neuroscience" title="European Archives of Psychiatry and Clinical Neuroscience">European Archives of Psychiatry and Clinical Neuroscience</a></i> gives the example of the problem of superficial characterization of psychiatric signs and symptoms . If a patient says they "feel depressed, sad, or down" there are actually a wide variety of underlying experiences they could be referencing: "not only <a href="/wiki/Depression_(mood)" title="Depression (mood)">depressed mood</a> but also, for instance, <a href="/wiki/Irritability" title="Irritability">irritation</a>, <a href="/wiki/Anger" title="Anger">anger</a>, loss of meaning, varieties of <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a>, <a href="/wiki/Ambivalence" title="Ambivalence">ambivalence</a>, <a href="/wiki/Rumination_(psychology)" title="Rumination (psychology)">ruminations</a> of different kinds, hyper-reflectivity, thought pressure, psychological <a href="/wiki/Anxiety" title="Anxiety">anxiety</a>, varieties of <a href="/wiki/Depersonalization" title="Depersonalization">depersonalization</a>, and even <a href="/wiki/Auditory_hallucination" title="Auditory hallucination">voices</a> with negative content, and so forth." This criticism is especially pertinent to the <a href="/wiki/Structured_interview" title="Structured interview">structured interview</a>, as simple "yes or no" questions may not be specific enough to truly confirm or deny the <a href="/wiki/Diagnostic_criteria" class="mw-redirect" title="Diagnostic criteria">diagnostic criterion</a> at issue. That is, whether a patient says yes or no will rely on their own understanding of the meaning of the various words in the question as well as their own interpretation of their experience. There is thus danger in being overconfident in the face value of the answers. The authors of the 2013 review give an example: A <a href="/wiki/Patient" title="Patient">patient</a> who was being administered the <a href="/wiki/Structured_Clinical_Interview_for_DSM-IV" class="mw-redirect" title="Structured Clinical Interview for DSM-IV">Structured Clinical Interview for the DSM-IV Axis I Disorders</a> denied <a href="/wiki/Thought_insertion" title="Thought insertion">thought insertion</a>, but during a "conversational, <a href="/wiki/Phenomenology_(psychology)" title="Phenomenology (psychology)">phenomenological</a> interview", a <a href="/wiki/Semi-structured_interview" title="Semi-structured interview">semi-structured interview</a> tailored to the patient, the same <a href="/wiki/Patient" title="Patient">patient</a> admitted to experiencing <a href="/wiki/Thought_insertion" title="Thought insertion">thought insertion</a>, along with a <a href="/wiki/Delusion" title="Delusion">delusional elaboration</a>. The authors suggested 2 reasons for this discrepancy: either the patient did not "recognize his own <a href="/wiki/Qualia" title="Qualia">experience</a> in the rather blunt, implicitly either/or formulation of the structured-interview question", or the <a href="/wiki/Qualia" title="Qualia">experience</a> did not "fully articulate itself" until the patient started talking about his experiences.<sup id="cite_ref-nordgaard1_115-0" class="reference"><a href="#cite_note-nordgaard1-115">[113]</a></sup>
</p>
<h3><span class="mw-headline" id="Obscuring_root_causes">Obscuring root causes</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=26" title="Edit section: Obscuring root causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<h4><span class="mw-headline" id="Economic_causes">Economic causes</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=27" title="Edit section: Economic causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<p>The DSM-5 has been criticized for overlooking <a href="/wiki/Capitalism" title="Capitalism">capitalism</a>’s interconnectivity with pathology.<sup id="cite_ref-116" class="reference"><a href="#cite_note-116">[114]</a></sup> One example is the development and treatment of diagnoses: around 69% of psychiatrists involved in the development of the <a href="/wiki/DSM-5" title="DSM-5">DSM-5</a> were reported to have financial ties to the <a href="/wiki/Pharmaceutical_industry" title="Pharmaceutical industry">pharmaceutical industry</a>.<sup id="cite_ref-117" class="reference"><a href="#cite_note-117">[115]</a></sup> These ties situate many care services within the <a href="/wiki/Medical%E2%80%93industrial_complex" title="Medical–industrial complex">medical-industrial complex</a>, a framework that prioritizes profit instead of the care of individuals.<sup id="cite_ref-118" class="reference"><a href="#cite_note-118">[116]</a></sup> Lane found the <a href="/wiki/Medical%E2%80%93industrial_complex" title="Medical–industrial complex">medical-industrial complex</a> intertwined with setting the parameters to diagnose conditions such as <a href="/wiki/Social_anxiety_disorder" title="Social anxiety disorder">social anxiety disorder</a>.<sup id="cite_ref-119" class="reference"><a href="#cite_note-119">[117]</a></sup> Other authors have supported similar findings.<sup id="cite_ref-120" class="reference"><a href="#cite_note-120">[118]</a></sup><sup id="cite_ref-121" class="reference"><a href="#cite_note-121">[119]</a></sup> Kincaid and Sullivan estimate that the cost of the industry surrounding diagnosis will rise to around six trillion dollars by 2030.<sup id="cite_ref-122" class="reference"><a href="#cite_note-122">[120]</a></sup>
</p><p>Scholars differ in the extent of <a href="/wiki/Capitalism" title="Capitalism">capitalism</a>'s influence on diagnosis. Davies supports the <a href="/wiki/Social_model_of_disability" title="Social model of disability">social model of disability</a> in explaining that diagnosis at present relies on considering conditions a consequence of a “broken brain.”<sup id="cite_ref-:10_123-0" class="reference"><a href="#cite_note-:10-123">[121]</a></sup> His wider logic on mental illness in response to societal issues problematizes diagnosis as a tool of the <a href="/wiki/Medical%E2%80%93industrial_complex#:~:text=December_2022),and_services_for_a_profit." title="Medical–industrial complex">medical-industrial complex</a>.<sup id="cite_ref-:10_123-1" class="reference"><a href="#cite_note-:10-123">[121]</a></sup> His previous book, <i>Cracked</i>, demonstrates the market interactions within the <a href="/wiki/Medical%E2%80%93industrial_complex#:~:text=December_2022),and_services_for_a_profit." title="Medical–industrial complex">medical-industrial complex</a>, as diagnosis becomes a source for monetization.<sup id="cite_ref-124" class="reference"><a href="#cite_note-124">[122]</a></sup>
</p><p>Others find that the dependency of patients on their psychiatric care providers makes the industry vulnerable to economic exploitation under <a href="/wiki/Capitalism" title="Capitalism">capitalism</a>.<sup id="cite_ref-:11_125-0" class="reference"><a href="#cite_note-:11-125">[123]</a></sup> These individuals argue that diagnosis is manipulated, but not caused, by capitalistic forces.<sup id="cite_ref-:11_125-1" class="reference"><a href="#cite_note-:11-125">[123]</a></sup> Academics have critiqued the directness of the association between the <a href="/wiki/Medical_model" title="Medical model">medical model</a>, <a href="/wiki/Capitalism" title="Capitalism">capitalism</a>, and diagnosis, but generally agree that characteristics of the capitalist system contribute to poor <a href="/wiki/Mental_health" title="Mental health">mental health</a>.<sup id="cite_ref-126" class="reference"><a href="#cite_note-126">[124]</a></sup>
</p>
<h4><span class="mw-headline" id="Institutional_causes">Institutional causes</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=28" title="Edit section: Institutional causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h4>
<p>Diagnoses of mental conditions have been used to obscure institutional practices of <a href="/wiki/Discrimination" title="Discrimination">discrimination</a>.<sup id="cite_ref-127" class="reference"><a href="#cite_note-127">[125]</a></sup> Late nineteenth-century diagnoses of white women with <a href="/wiki/Hysteria" title="Hysteria">hysteria</a>, for instance, were said to be caused by “overcivilization,” shaped by racially discriminatory <a href="/wiki/Social_Darwinism" title="Social Darwinism">Social Darwinism</a>.<sup id="cite_ref-128" class="reference"><a href="#cite_note-128">[126]</a></sup> Similarly, American physician <a href="/wiki/Samuel_A._Cartwright" title="Samuel A. Cartwright">Samuel Cartwright</a> coined "<a href="/wiki/Drapetomania" title="Drapetomania">drapetomania</a>" in 1851 as a mental condition which "caused" slaves to escape captivity.<sup id="cite_ref-129" class="reference"><a href="#cite_note-129">[127]</a></sup> In the present day, Brinkmann finds that “contemporary diagnostic cultures,” whereby humans assess their conditions through a psychiatric lens, can “risk losing sight of the larger historical and social forces that affect [their] lives.”<sup id="cite_ref-:12_130-0" class="reference"><a href="#cite_note-:12-130">[128]</a></sup> Contemporary diagnostic cultures help explain how diagnosis reflect larger historical biases.<sup id="cite_ref-:12_130-1" class="reference"><a href="#cite_note-:12-130">[128]</a></sup><sup id="cite_ref-:13_131-0" class="reference"><a href="#cite_note-:13-131">[129]</a></sup>
</p><p>Critics have argued that the DSM-5's criteria pathologize a wide range of people with distress or impairment. Chapman et al. discuss the implications for obscuring distress in the <a href="/wiki/Imprisonment" title="Imprisonment">incarceration and confinement</a> of "intellectually disabled" populations; they argue that "differentiation based on <a href="/wiki/Intellectual_disability" title="Intellectual disability">psychiatric and intellectual disability</a>" is arbitrarily set and altered based on <a href="/wiki/Capitalism" title="Capitalism">capitalism</a>'s needs for "mobile and free workers."<sup id="cite_ref-132" class="reference"><a href="#cite_note-132">[130]</a></sup> Metzl demonstrates that the shifting diagnostic parameters of <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a> became a method for institutionalizing Black men during the <a href="/wiki/Civil_rights_movement" title="Civil rights movement">Civil Rights Movement</a>.<sup id="cite_ref-:13_131-1" class="reference"><a href="#cite_note-:13-131">[129]</a></sup> In sum, those who have experienced “domination” or “exploitation” based on an identity trait are more likely to be pathologized through diagnosis.<sup id="cite_ref-133" class="reference"><a href="#cite_note-133">[131]</a></sup>
</p>
<h3><span class="mw-headline" id="Overdiagnosis">Overdiagnosis</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=29" title="Edit section: Overdiagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p><a href="/wiki/Allen_Frances" title="Allen Frances">Allen Frances</a>, an outspoken critic of DSM-5, states that "normality is an endangered species," because of "fad diagnoses" and an "epidemic" of over-diagnosing, and suggests that the "DSM-5 threatens to provoke several more [epidemics]."<sup id="cite_ref-134" class="reference"><a href="#cite_note-134">[132]</a></sup><sup id="cite_ref-135" class="reference"><a href="#cite_note-135">[133]</a></sup> Some researchers state that changes in diagnostic criteria, following each published version of the DSM, reduce thresholds for a diagnosis, which results in increases in prevalence rates for ADHD and <a href="/wiki/Autism_spectrum" title="Autism spectrum">autism spectrum disorder</a>.<sup id="cite_ref-136" class="reference"><a href="#cite_note-136">[134]</a></sup><sup id="cite_ref-bruchmuller_2012_137-0" class="reference"><a href="#cite_note-bruchmuller_2012-137">[135]</a></sup><sup id="cite_ref-138" class="reference"><a href="#cite_note-138">[136]</a></sup><sup id="cite_ref-139" class="reference"><a href="#cite_note-139">[137]</a></sup> Bruchmüller, et al. (2012) suggest that as a factor that may lead to overdiagnosis are situations when the clinical judgment of the diagnostician regarding a diagnosis (ADHD) is affected by <a href="/wiki/Heuristic" title="Heuristic">heuristics</a>.<sup id="cite_ref-bruchmuller_2012_137-1" class="reference"><a href="#cite_note-bruchmuller_2012-137">[135]</a></sup>
</p>
<h3><span class="mw-headline" id="Dividing_lines">Dividing lines</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=30" title="Edit section: Dividing lines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>Despite caveats in the introduction to the DSM, it has long been argued that its <a href="/wiki/Classification_of_mental_disorders" title="Classification of mental disorders">system of classification</a> makes unjustified categorical distinctions between disorders and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM <a href="/wiki/Syndromes" class="mw-redirect" title="Syndromes">syndromes</a>, or between a common DSM syndrome and normality, have failed.<sup id="cite_ref-concept&evolution_9-3" class="reference"><a href="#cite_note-concept&evolution-9">[9]</a></sup> Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.<sup id="cite_ref-140" class="reference"><a href="#cite_note-140">[138]</a></sup><sup id="cite_ref-141" class="reference"><a href="#cite_note-141">[139]</a></sup><sup id="cite_ref-142" class="reference"><a href="#cite_note-142">[140]</a></sup>
</p><p>In addition, it is argued that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.<sup id="cite_ref-143" class="reference"><a href="#cite_note-143">[141]</a></sup> The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.
</p><p>Because an individual's degree of impairment is often not correlated with symptom counts and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.<sup id="cite_ref-144" class="reference"><a href="#cite_note-144">[142]</a></sup> On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life.
</p>
<h3><span class="mw-headline" id="Cultural_bias">Cultural bias</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=31" title="Edit section: Cultural bias"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>Psychiatrists have argued that published diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.<sup id="cite_ref-Widiger2000_145-0" class="reference"><a href="#cite_note-Widiger2000-145">[143]</a></sup> Advocating a more <a href="/wiki/Culturally_sensitive" class="mw-redirect" title="Culturally sensitive">culturally sensitive</a> approach to psychology, critics such as <a href="/wiki/Carl_Bell_(physician)" title="Carl Bell (physician)">Carl Bell</a> and Marcello Maviglia contend that researchers and service-providers often discount the cultural and ethnic diversity of individuals.<sup id="cite_ref-wash-post_146-0" class="reference"><a href="#cite_note-wash-post-146">[144]</a></sup> In addition, current diagnostic guidelines have been criticized<sup id="cite_ref-147" class="reference"><a href="#cite_note-147">[145]</a></sup> as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criterion-set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.<sup id="cite_ref-Widiger2000_145-1" class="reference"><a href="#cite_note-Widiger2000-145">[143]</a></sup> <a href="/wiki/Cross-cultural_psychiatry" title="Cross-cultural psychiatry">Cross-cultural</a> psychiatrist <a href="/wiki/Arthur_Kleinman" title="Arthur Kleinman">Arthur Kleinman</a> contends that Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.<sup id="cite_ref-148" class="reference"><a href="#cite_note-148">[146]</a></sup> Other cross-cultural critics largely share Kleinman's negative view toward the <a href="/wiki/Culture-bound_syndrome" title="Culture-bound syndrome">culture-bound syndrome</a>, common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.<sup id="cite_ref-149" class="reference"><a href="#cite_note-149">[147]</a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="This citation requires a reference to the specific page or range of pages in which the material appears. (August 2016)">page needed</span></a></i>]</sup>
</p><p>Mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.<sup id="cite_ref-Widiger2000_145-2" class="reference"><a href="#cite_note-Widiger2000-145">[143]</a></sup> One result of this dissatisfaction was the development of the Azibo Nosology by Daudi Ajani Ya Azibo as an alternative to the DSM in treating patients of the <a href="/wiki/African_diaspora" title="African diaspora">African diaspora</a>.<sup id="cite_ref-150" class="reference"><a href="#cite_note-150">[148]</a></sup><sup id="cite_ref-151" class="reference"><a href="#cite_note-151">[149]</a></sup><sup id="cite_ref-152" class="reference"><a href="#cite_note-152">[150]</a></sup>
</p><p>Historically, the DSM tended to avoid issues involving <a href="/wiki/Religion" title="Religion">religion</a>; the DSM-5 relaxed this attitude somewhat.<sup id="cite_ref-153" class="reference"><a href="#cite_note-153">[151]</a></sup>
</p>
<h3><span class="mw-headline" id="Medicalization_and_financial_conflicts_of_interest">Medicalization and financial conflicts of interest</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=32" title="Edit section: Medicalization and financial conflicts of interest"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>There was extensive analysis and comment on DSM-IV (published in 1994) in the years leading up to the 2013 publication of DSM-5. It was alleged that the way the categories of DSM-IV were structured, as well as the substantial expansion of the number of categories within it, represented increasing <a href="/wiki/Medicalization" title="Medicalization">medicalization</a> of human nature, very possibly attributable to <a href="/wiki/Disease_mongering" title="Disease mongering">disease mongering</a> by psychiatrists and <a href="/wiki/Pharmaceutical_companies" class="mw-redirect" title="Pharmaceutical companies">pharmaceutical companies</a>, the power and influence of the latter having grown dramatically in recent decades.<sup id="cite_ref-154" class="reference"><a href="#cite_note-154">[152]</a></sup> In 2005, then APA President <a href="/wiki/Steven_Sharfstein" title="Steven Sharfstein">Steven Sharfstein</a> released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".<sup id="cite_ref-155" class="reference"><a href="#cite_note-155">[153]</a></sup> It was reported that of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had financial relationships with the pharmaceutical industry during the period 1989–2004, raising the prospect of a direct <a href="/wiki/Conflict_of_interest#Relationship_to_medical_research" title="Conflict of interest">conflict of interest</a>. The same article concluded that the connections between panel members and the drug companies were particularly strong involving those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.
</p><p><a href="/wiki/William_Glasser" title="William Glasser">William Glasser</a> referred to DSM-IV as having "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".<sup id="cite_ref-156" class="reference"><a href="#cite_note-156">[154]</a></sup> A 2012 article in <i><a href="/wiki/The_New_York_Times" title="The New York Times">The New York Times</a></i> commented sharply that DSM-IV (then in its 18th year), through copyrights held closely by the APA, had earned the Association over $100 million.<sup id="cite_ref-Greenberg_157-0" class="reference"><a href="#cite_note-Greenberg-157">[155]</a></sup>
</p><p>However, although the number of identified diagnoses had increased by more than 300% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argued that this almost entirely represented greater specification of the forms of pathology, thereby allowing better grouping of similar patients.<sup id="cite_ref-concept&evolution_9-4" class="reference"><a href="#cite_note-concept&evolution-9">[9]</a></sup>
</p>
<h3><span class="mw-headline" id="Potential_harm_of_labels">Potential harm of labels</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=33" title="Edit section: Potential harm of labels"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>A core function of the DSM is the categorization of people's experiences into diagnoses based on symptoms. However, there is disagreement about the use of diagnoses as labels. Some individuals are relieved to find they have a recognized condition that they can apply a name to, and this has led to many people <a href="/wiki/Self-diagnosis" title="Self-diagnosis">self-diagnosing</a>.<sup id="cite_ref-158" class="reference"><a href="#cite_note-158">[156]</a></sup> Others, however, question the accuracy of diagnosis, or feel they have been given a label that invites <a href="/wiki/Social_stigma" title="Social stigma">social stigma</a> and <a href="/wiki/Discrimination" title="Discrimination">discrimination</a> (the terms "<a href="/wiki/Mentalism_(discrimination)" class="mw-redirect" title="Mentalism (discrimination)">mentalism</a>" and "sanism" have been used to describe such discriminatory treatment).<sup id="cite_ref-Sane_159-0" class="reference"><a href="#cite_note-Sane-159">[157]</a></sup>
</p><p>Diagnoses can become <a href="/wiki/Internalization_(psychology)" class="mw-redirect" title="Internalization (psychology)">internalized</a> and affect an individual's <a href="/wiki/Self-identity" class="mw-redirect" title="Self-identity">self-identity</a>, and some psychotherapists have found that the healing process can be inhibited and symptoms can worsen as a result.<sup id="cite_ref-160" class="reference"><a href="#cite_note-160">[158]</a></sup> Some members of the <a href="/wiki/Psychiatric_survivors_movement" title="Psychiatric survivors movement">psychiatric survivors movement</a> (more broadly the consumer/survivor/ex-patient movement) actively campaign against their diagnoses, or the assumed implications, or against the DSM system in general.<sup id="cite_ref-CapeTown_161-0" class="reference"><a href="#cite_note-CapeTown-161">[159]</a></sup><sup id="cite_ref-Medscape_162-0" class="reference"><a href="#cite_note-Medscape-162">[160]</a></sup> Additionally, it has been noted that the DSM often uses definitions and terminology that are inconsistent with a <a href="/wiki/Recovery_model" title="Recovery model">recovery model</a>, and such content can erroneously imply excess psychopathology (e.g. multiple "<a href="/wiki/Comorbid" class="mw-redirect" title="Comorbid">comorbid</a>" diagnoses) or <a href="/wiki/Chronic_(medicine)" class="mw-redirect" title="Chronic (medicine)">chronicity</a>.<sup id="cite_ref-Medscape_162-1" class="reference"><a href="#cite_note-Medscape-162">[160]</a></sup>
</p>
<h3><span class="mw-headline" id="Critiques_of_DSM-5">Critiques of DSM-5</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=34" title="Edit section: Critiques of DSM-5"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>Psychiatrist <a href="/wiki/Allen_Frances" title="Allen Frances">Allen Frances</a> has been critical of proposed revisions to the DSM–5. In a 2012 <i>New York Times</i> editorial, Frances warned that if this DSM version is issued unamended by the APA, "it will medicalize normality and result in a glut of unnecessary and harmful drug prescription."<sup id="cite_ref-nyt_163-0" class="reference"><a href="#cite_note-nyt-163">[161]</a></sup>
</p><p>In a December 2012, blog post on <i><a href="/wiki/Psychology_Today" title="Psychology Today">Psychology Today</a></i>, Frances provides his "list of DSM 5's ten most potentially harmful changes:"<sup id="cite_ref-dsm5GuideNotBible_164-0" class="reference"><a href="#cite_note-dsm5GuideNotBible-164">[162]</a></sup>
</p>
<ul><li>Disruptive Mood Dysregulation Disorder, for temper tantrums</li>
<li>Major Depressive Disorder, includes normal grief</li>
<li>Minor Neurocognitive Disorder, for normal forgetfulness in old age</li>
<li>Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants</li>
<li>Binge Eating Disorder, for excessive eating</li>
<li>Autism, defining the disorder more specifically, possibly leading to decreased rates of diagnosis and the disruption of school services</li>
<li>First-time drug users will be lumped in with addicts</li>
<li>Behavioral Addictions, making a "mental disorder of everything we like to do a lot."</li>
<li>Generalized Anxiety Disorder, includes everyday worries</li>
<li>Post-traumatic stress disorder, changes "opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."<sup id="cite_ref-dsm5GuideNotBible_164-1" class="reference"><a href="#cite_note-dsm5GuideNotBible-164">[162]</a></sup></li></ul>
<p>A group of 25 psychiatrists and researchers, among whom were Frances and <a href="/wiki/Thomas_Szasz" title="Thomas Szasz">Thomas Szasz</a>, have published debates on what they see as the six most essential questions in psychiatric diagnosis:<sup id="cite_ref-Phillips_165-0" class="reference"><a href="#cite_note-Phillips-165">[163]</a></sup>
</p>
<ul><li>Are they more like theoretical constructs or more like diseases?</li>
<li>How to reach an agreed definition?</li>
<li>Should the DSM-5 take a cautious or conservative approach?</li>
<li>What is the role of practical rather than scientific considerations?</li>
<li>How should it be used by clinicians or researchers?</li>
<li>Is an entirely different diagnostic system required?</li></ul>
<p>In 2011, psychologist <a href="/wiki/Brent_Robbins" title="Brent Robbins">Brent Robbins</a> co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Over 15,000 individuals and <a href="/wiki/Mental_health" title="Mental health">mental health</a> professionals have signed a petition in support of the letter.<sup id="cite_ref-pointpark_166-0" class="reference"><a href="#cite_note-pointpark-166">[164]</a></sup> Thirteen other APA divisions have endorsed the petition.<sup id="cite_ref-pointpark_166-1" class="reference"><a href="#cite_note-pointpark-166">[164]</a></sup> Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.<sup id="cite_ref-167" class="reference"><a href="#cite_note-167">[165]</a></sup>
</p>
<h2><span class="mw-headline" id="See_also">See also</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=35" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 30em;">
<ul><li><a href="/wiki/Chinese_Classification_and_Diagnostic_Criteria_of_Mental_Disorders" class="mw-redirect" title="Chinese Classification and Diagnostic Criteria of Mental Disorders">Chinese Classification and Diagnostic Criteria of Mental Disorders</a></li>
<li><a href="/wiki/Classification_of_mental_disorders" title="Classification of mental disorders">Classification of mental disorders</a></li>
<li><a href="/wiki/Diagnostic_classification_and_rating_scales_used_in_psychiatry" class="mw-redirect" title="Diagnostic classification and rating scales used in psychiatry">Diagnostic classification and rating scales used in psychiatry</a></li>
<li><a href="/wiki/DSM-IV_Codes" class="mw-redirect" title="DSM-IV Codes">DSM-IV Codes</a></li>
<li><a href="/wiki/Global_Assessment_of_Functioning" title="Global Assessment of Functioning">Global Assessment of Functioning (GAF) Scale</a></li>
<li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">International Statistical Classification of Diseases and Related Health Problems (ICD)</a></li>
<li><a href="/wiki/Kraepelinian_dichotomy" title="Kraepelinian dichotomy">Kraepelinian dichotomy</a></li>
<li><a href="/wiki/Psychodynamic_Diagnostic_Manual" title="Psychodynamic Diagnostic Manual">Psychodynamic Diagnostic Manual</a></li>
<li><a href="/wiki/Relational_disorder" title="Relational disorder">Relational disorder</a> (proposed DSM-5 new diagnosis)</li>
<li><a href="/wiki/Research_Domain_Criteria" title="Research Domain Criteria">Research Domain Criteria</a> (RDoC), a framework being developed by the National Institute of Mental Health</li>
<li><a href="/wiki/Rosenhan_experiment" title="Rosenhan experiment">Rosenhan experiment</a></li>
<li><a href="/wiki/Structured_Clinical_Interview_for_DSM-IV" class="mw-redirect" title="Structured Clinical Interview for DSM-IV">Structured Clinical Interview for DSM-IV</a> <i>(SCID)</i></li>
<li><a href="/wiki/Homosexuality_in_DSM" class="mw-redirect" title="Homosexuality in DSM">Homosexuality in DSM</a></li></ul>
</div>
<h2><span class="mw-headline" id="Notes">Notes</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=36" title="Edit section: Notes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<style data-mw-deduplicate="TemplateStyles:r1217336898">.mw-parser-output .reflist{font-size:90%;margin-bottom:0.5em;list-style-type:decimal}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-lower-alpha">
<div class="mw-references-wrap"><ol class="references">
<li id="cite_note-57"><span class="mw-cite-backlink"><b><a href="#cite_ref-57">^</a></b></span> <span class="reference-text">Determining the correct DSM-II printing where the change occurred can be confusing because the American Psychiatric Association publication that announced the change is titled, in part, "Proposed change in DSM-II, 6th printing, page 44". However, a notice in that publication indicates that "the change appears on page 44 of this, the seventh printing."</span>
</li>
<li id="cite_note-92"><span class="mw-cite-backlink"><b><a href="#cite_ref-92">^</a></b></span> <span class="reference-text">However, this planned change was not adopted for the initial revision of the DSM-5, which is named DSM-5-TR, in accordance with past convention.</span>
</li>
</ol></div></div>
<h2><span class="mw-headline" id="References">References</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=37" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1217336898"><div class="reflist reflist-columns references-column-width" style="column-width: 30em;">
<ol class="references">
<li id="cite_note-:1-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-:1_1-0">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1215172403">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a{background-size:contain}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a{background-size:contain}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a{background-size:contain}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:#d33}.mw-parser-output .cs1-visible-error{color:#d33}.mw-parser-output .cs1-maint{display:none;color:#2C882D;margin-left:0.3em}.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911F}html.skin-theme-clientpref-night .mw-parser-output .cs1-visible-error,html.skin-theme-clientpref-night .mw-parser-output .cs1-hidden-error{color:#f8a397}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-visible-error,html.skin-theme-clientpref-os .mw-parser-output .cs1-hidden-error{color:#f8a397}html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911F}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf">"DSM-5 Full Text Online"</a> <span class="cs1-format">(PDF)</span><span class="reference-accessdate">. Retrieved <span class="nowrap">January 10,</span> 2022</span> – via Archive.Today.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=DSM-5+Full+Text+Online&rft_id=http%3A%2F%2Frepository.poltekkes-kaltim.ac.id%2F657%2F1%2FDiagnostic%2520and%2520statistical%2520manual%2520of%2520mental%2520disorders%2520_%2520DSM-5%2520%28%2520PDFDrive.com%2520%29.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.afr.com/policy/health-and-education/how-australia-adopted-america-s-bible-of-psychiatry-20210419-p57kjr">"How Australia adopted America's bible of psychiatry"</a>. <i>Australian Financial Review</i>. April 30, 2021<span class="reference-accessdate">. Retrieved <span class="nowrap">January 24,</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Australian+Financial+Review&rft.atitle=How+Australia+adopted+America%27s+bible+of+psychiatry&rft.date=2021-04-30&rft_id=https%3A%2F%2Fwww.afr.com%2Fpolicy%2Fhealth-and-education%2Fhow-australia-adopted-america-s-bible-of-psychiatry-20210419-p57kjr&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Do_mental_health_professionals_use_diagnostic_classifications_the_way_we_think_they_do?_A_global_survey-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-Do_mental_health_professionals_use_diagnostic_classifications_the_way_we_think_they_do?_A_global_survey_3-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFirstRebelloKeeleyBhargava2018" class="citation journal cs1">First M, Rebello T, Keeley J, Bhargava R, Dai Y, Kulygina M, Matsumoto C, Robles R, Stona A, Reed G (June 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980454">"Do mental health professionals use diagnostic classifications the way we think they do? A global survey"</a>. <i>World Psychiatry</i>. <b>17</b> (2): 187–195. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fwps.20525">10.1002/wps.20525</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980454">5980454</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29856559">29856559</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=World+Psychiatry&rft.atitle=Do+mental+health+professionals+use+diagnostic+classifications+the+way+we+think+they+do%3F+A+global+survey&rft.volume=17&rft.issue=2&rft.pages=187-195&rft.date=2018-06&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5980454%23id-name%3DPMC&rft_id=info%3Apmid%2F29856559&rft_id=info%3Adoi%2F10.1002%2Fwps.20525&rft.aulast=First&rft.aufirst=M&rft.au=Rebello%2C+T&rft.au=Keeley%2C+J&rft.au=Bhargava%2C+R&rft.au=Dai%2C+Y&rft.au=Kulygina%2C+M&rft.au=Matsumoto%2C+C&rft.au=Robles%2C+R&rft.au=Stona%2C+A&rft.au=Reed%2C+G&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5980454&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Comparative_efficacy_and_acceptability_of_21_antidepressant_drugs_for_the_acute_treatment_of_adults_with_major_depressive_disorder:_a_systematic_review_and_network_meta-analysis-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-Comparative_efficacy_and_acceptability_of_21_antidepressant_drugs_for_the_acute_treatment_of_adults_with_major_depressive_disorder:_a_systematic_review_and_network_meta-analysis_4-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCiprianiFurukawaSalantiChaimani2018" class="citation journal cs1">Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JP, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JP, Geddes JR (April 7, 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788">"Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis"</a>. <i>The Lancet</i>. <b>391</b> (10128): 1357–1366. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0140-6736%2817%2932802-7">10.1016/S0140-6736(17)32802-7</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788">5889788</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29477251">29477251</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Lancet&rft.atitle=Comparative+efficacy+and+acceptability+of+21+antidepressant+drugs+for+the+acute+treatment+of+adults+with+major+depressive+disorder%3A+a+systematic+review+and+network+meta-analysis&rft.volume=391&rft.issue=10128&rft.pages=1357-1366&rft.date=2018-04-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5889788%23id-name%3DPMC&rft_id=info%3Apmid%2F29477251&rft_id=info%3Adoi%2F10.1016%2FS0140-6736%2817%2932802-7&rft.aulast=Cipriani&rft.aufirst=A&rft.au=Furukawa%2C+TA&rft.au=Salanti%2C+G&rft.au=Chaimani%2C+A&rft.au=Atkinson%2C+LZ&rft.au=Ogawa%2C+Y&rft.au=Leucht%2C+S&rft.au=Ruhe%2C+HG&rft.au=Turner%2C+EH&rft.au=Higgins%2C+JP&rft.au=Egger%2C+M&rft.au=Takeshima%2C+N&rft.au=Hayasaka%2C+Y&rft.au=Imai%2C+H&rft.au=Shinohara%2C+K&rft.au=Tajika%2C+A&rft.au=Ioannidis%2C+JP&rft.au=Geddes%2C+JR&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5889788&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBandelowReittRöverMichaelis2015" class="citation journal cs1">Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D (July 2015). "Efficacy of treatments for anxiety disorders: a meta-analysis". <i>International Clinical Psychopharmacology</i>. <b>30</b> (4): 183–192. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FYIC.0000000000000078">10.1097/YIC.0000000000000078</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0268-1315">0268-1315</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25932596">25932596</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:24088074">24088074</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=International+Clinical+Psychopharmacology&rft.atitle=Efficacy+of+treatments+for+anxiety+disorders%3A+a+meta-analysis&rft.volume=30&rft.issue=4&rft.pages=183-192&rft.date=2015-07&rft.issn=0268-1315&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A24088074%23id-name%3DS2CID&rft_id=info%3Apmid%2F25932596&rft_id=info%3Adoi%2F10.1097%2FYIC.0000000000000078&rft.aulast=Bandelow&rft.aufirst=B&rft.au=Reitt%2C+M&rft.au=R%C3%B6ver%2C+C&rft.au=Michaelis%2C+S&rft.au=G%C3%B6rlich%2C+Y&rft.au=Wedekind%2C+D&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSchneider-ThomaChalkouDörriesBighelli2022" class="citation journal cs1">Schneider-Thoma J, Chalkou K, Dörries C, Bighelli I, Ceraso A, Huhn M, Siafis S, Davis JM, Cipriani A, Furukawa TA, Salanti G, Leucht S (February 26, 2022). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0140-6736%2821%2901997-8">"Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis"</a>. <i>Lancet</i>. <b>399</b> (10327): 824–836. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0140-6736%2821%2901997-8">10.1016/S0140-6736(21)01997-8</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0140-6736">0140-6736</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35219395">35219395</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:247087411">247087411</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Lancet&rft.atitle=Comparative+efficacy+and+tolerability+of+32+oral+and+long-acting+injectable+antipsychotics+for+the+maintenance+treatment+of+adults+with+schizophrenia%3A+a+systematic+review+and+network+meta-analysis&rft.volume=399&rft.issue=10327&rft.pages=824-836&rft.date=2022-02-26&rft.issn=0140-6736&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A247087411%23id-name%3DS2CID&rft_id=info%3Apmid%2F35219395&rft_id=info%3Adoi%2F10.1016%2FS0140-6736%2821%2901997-8&rft.aulast=Schneider-Thoma&rft.aufirst=J&rft.au=Chalkou%2C+K&rft.au=D%C3%B6rries%2C+C&rft.au=Bighelli%2C+I&rft.au=Ceraso%2C+A&rft.au=Huhn%2C+M&rft.au=Siafis%2C+S&rft.au=Davis%2C+JM&rft.au=Cipriani%2C+A&rft.au=Furukawa%2C+TA&rft.au=Salanti%2C+G&rft.au=Leucht%2C+S&rft_id=https%3A%2F%2Fdoi.org%2F10.1016%252FS0140-6736%252821%252901997-8&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-7">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGartlehnerCrottyKennedyEdlund2021" class="citation journal cs1">Gartlehner G, Crotty K, Kennedy S, Edlund MJ, Ali R, Siddiqui M, Fortman R, Wines R, Persad E, Viswanathan M (October 2021). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478737">"Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis"</a>. <i>CNS Drugs</i>. <b>35</b> (10): 1053–1067. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs40263-021-00855-4">10.1007/s40263-021-00855-4</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/1172-7047">1172-7047</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478737">8478737</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34495494">34495494</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=CNS+Drugs&rft.atitle=Pharmacological+Treatments+for+Borderline+Personality+Disorder%3A+A+Systematic+Review+and+Meta-Analysis&rft.volume=35&rft.issue=10&rft.pages=1053-1067&rft.date=2021-10&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8478737%23id-name%3DPMC&rft.issn=1172-7047&rft_id=info%3Apmid%2F34495494&rft_id=info%3Adoi%2F10.1007%2Fs40263-021-00855-4&rft.aulast=Gartlehner&rft.aufirst=G&rft.au=Crotty%2C+K&rft.au=Kennedy%2C+S&rft.au=Edlund%2C+MJ&rft.au=Ali%2C+R&rft.au=Siddiqui%2C+M&rft.au=Fortman%2C+R&rft.au=Wines%2C+R&rft.au=Persad%2C+E&rft.au=Viswanathan%2C+M&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8478737&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-frana-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-frana_8-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFrances2013" class="citation web cs1"><a href="/wiki/Allen_Frances" title="Allen Frances">Frances A</a> (May 17, 2013). <a rel="nofollow" class="external text" href="http://annals.org/article.aspx?articleid=1688399">"The New Crisis in Confidence in Psychiatric Diagnosis"</a>. <i>Annals of Internal Medicine</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Annals+of+Internal+Medicine&rft.atitle=The+New+Crisis+in+Confidence+in+Psychiatric+Diagnosis&rft.date=2013-05-17&rft.aulast=Frances&rft.aufirst=A&rft_id=http%3A%2F%2Fannals.org%2Farticle.aspx%3Farticleid%3D1688399&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-concept&evolution-9"><span class="mw-cite-backlink">^ <a href="#cite_ref-concept&evolution_9-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-concept&evolution_9-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-concept&evolution_9-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-concept&evolution_9-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-concept&evolution_9-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFDalalSivakumar2009" class="citation journal cs1">Dalal PK, Sivakumar T (2009). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802383">"Moving towards ICD-11 and DSM-V: Concept and evolution of psychiatric classification"</a>. <i>Indian Journal of Psychiatry</i>. <b>51</b> (4): 310–319. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4103%2F0019-5545.58302">10.4103/0019-5545.58302</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802383">2802383</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20048461">20048461</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Indian+Journal+of+Psychiatry&rft.atitle=Moving+towards+ICD-11+and+DSM-V%3A+Concept+and+evolution+of+psychiatric+classification&rft.volume=51&rft.issue=4&rft.pages=310-319&rft.date=2009&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2802383%23id-name%3DPMC&rft_id=info%3Apmid%2F20048461&rft_id=info%3Adoi%2F10.4103%2F0019-5545.58302&rft.aulast=Dalal&rft.aufirst=PK&rft.au=Sivakumar%2C+T&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2802383&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKendellJablensky2003" class="citation journal cs1">Kendell R, Jablensky A (January 2003). "Distinguishing between the validity and utility of psychiatric diagnoses". <i>The American Journal of Psychiatry</i>. <b>160</b> (1): 4–12. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ajp.160.1.4">10.1176/appi.ajp.160.1.4</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12505793">12505793</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:16151623">16151623</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=Distinguishing+between+the+validity+and+utility+of+psychiatric+diagnoses&rft.volume=160&rft.issue=1&rft.pages=4-12&rft.date=2003-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A16151623%23id-name%3DS2CID&rft_id=info%3Apmid%2F12505793&rft_id=info%3Adoi%2F10.1176%2Fappi.ajp.160.1.4&rft.aulast=Kendell&rft.aufirst=R&rft.au=Jablensky%2C+A&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-11"><span class="mw-cite-backlink"><b><a href="#cite_ref-11">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBaca-GarciaPerez-RodriguezBasurte-VillamorFernandez_del_Moral2007" class="citation journal cs1">Baca-Garcia E, Perez-Rodriguez MM, Basurte-Villamor I, Fernandez del Moral AL, Jimenez-Arriero MA, Gonzalez de Rivera JL, et al. (March 2007). <a rel="nofollow" class="external text" href="https://doi.org/10.1192%2Fbjp.bp.106.024026">"Diagnostic stability of psychiatric disorders in clinical practice"</a>. <i>The British Journal of Psychiatry</i>. <b>190</b> (3): 210–216. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1192%2Fbjp.bp.106.024026">10.1192/bjp.bp.106.024026</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17329740">17329740</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:4888348">4888348</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+British+Journal+of+Psychiatry&rft.atitle=Diagnostic+stability+of+psychiatric+disorders+in+clinical+practice&rft.volume=190&rft.issue=3&rft.pages=210-216&rft.date=2007-03&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A4888348%23id-name%3DS2CID&rft_id=info%3Apmid%2F17329740&rft_id=info%3Adoi%2F10.1192%2Fbjp.bp.106.024026&rft.aulast=Baca-Garcia&rft.aufirst=E&rft.au=Perez-Rodriguez%2C+MM&rft.au=Basurte-Villamor%2C+I&rft.au=Fernandez+del+Moral%2C+AL&rft.au=Jimenez-Arriero%2C+MA&rft.au=Gonzalez+de+Rivera%2C+JL&rft.au=Saiz-Ruiz%2C+J&rft.au=Oquendo%2C+MA&rft_id=https%3A%2F%2Fdoi.org%2F10.1192%252Fbjp.bp.106.024026&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFPincusZarinFirst1998" class="citation journal cs1">Pincus HA, Zarin DA, First M (December 1998). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20070929134334/http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145">"<span class="cs1-kern-left"></span>'Clinical significance' and DSM-IV"</a>. <i>Archives of General Psychiatry</i>. <b>55</b> (12): 1145, author reply 1147–1145, author reply 1148. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchpsyc.55.12.1145">10.1001/archpsyc.55.12.1145</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9862559">9862559</a>. Archived from <a rel="nofollow" class="external text" href="http://archpsyc.ama-assn.org/cgi/content/extract/55/12/1145">the original</a> on September 29, 2007.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+General+Psychiatry&rft.atitle=%27Clinical+significance%27+and+DSM-IV&rft.volume=55&rft.issue=12&rft.pages=1145%2C+author+reply+1147-1145%2C+author+reply+1148&rft.date=1998-12&rft_id=info%3Adoi%2F10.1001%2Farchpsyc.55.12.1145&rft_id=info%3Apmid%2F9862559&rft.aulast=Pincus&rft.aufirst=HA&rft.au=Zarin%2C+DA&rft.au=First%2C+M&rft_id=http%3A%2F%2Farchpsyc.ama-assn.org%2Fcgi%2Fcontent%2Fextract%2F55%2F12%2F1145&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-DSM-5_Field_Trials_in_the_United_States_and_Canada,_Part_II:_Test-Retest_Reliability_of_Selected_Categorical_Diagnoses-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-DSM-5_Field_Trials_in_the_United_States_and_Canada,_Part_II:_Test-Retest_Reliability_of_Selected_Categorical_Diagnoses_13-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFRegierNarrowClarkeKraemer2013" class="citation journal cs1">Regier D, Narrow W, Clarke D, Kraemer H, Kuramoto S, Kuhl E, Kupfer D (2013). "DSM-5 Field Trials in the United States and Canada, Part II: Test-Retest Reliability of Selected Categorical Diagnoses". <i>American Journal of Psychiatry</i>. <b>170</b> (1): 59–70. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ajp.2012.12070999">10.1176/appi.ajp.2012.12070999</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23111466">23111466</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Journal+of+Psychiatry&rft.atitle=DSM-5+Field+Trials+in+the+United+States+and+Canada%2C+Part+II%3A+Test-Retest+Reliability+of+Selected+Categorical+Diagnoses&rft.volume=170&rft.issue=1&rft.pages=59-70&rft.date=2013&rft_id=info%3Adoi%2F10.1176%2Fappi.ajp.2012.12070999&rft_id=info%3Apmid%2F23111466&rft.aulast=Regier&rft.aufirst=D&rft.au=Narrow%2C+W&rft.au=Clarke%2C+D&rft.au=Kraemer%2C+H&rft.au=Kuramoto%2C+S&rft.au=Kuhl%2C+E&rft.au=Kupfer%2C+D&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><i><a href="/wiki/ICD-10" title="ICD-10">ICD-10 Classification of Mental and Behavioural Disorders</a>:</i>
"<a rel="nofollow" class="external text" href="https://www.who.int/classifications/icd/en/bluebook.pdf">Clinical descriptions and diagnostic guidelines</a>" (aka the "Blue Book"); and
"<a rel="nofollow" class="external text" href="https://www.who.int/classifications/icd/en/GRNBOOK.pdf">Diagnostic criteria for research</a>" (aka the "Green Book").</span>
</li>
<li id="cite_note-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-15">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMezzich2002" class="citation journal cs1">Mezzich JE (2002). "International surveys on the use of ICD-10 and related diagnostic systems". <i>Psychopathology</i>. <b>35</b> (2–3): 72–75. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000065122">10.1159/000065122</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12145487">12145487</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:35857872">35857872</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychopathology&rft.atitle=International+surveys+on+the+use+of+ICD-10+and+related+diagnostic+systems&rft.volume=35&rft.issue=2%E2%80%933&rft.pages=72-75&rft.date=2002&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A35857872%23id-name%3DS2CID&rft_id=info%3Apmid%2F12145487&rft_id=info%3Adoi%2F10.1159%2F000065122&rft.aulast=Mezzich&rft.aufirst=JE&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:2-16"><span class="mw-cite-backlink">^ <a href="#cite_ref-:2_16-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:2_16-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFTyrer2014" class="citation journal cs1">Tyrer, Peter (2014). <a rel="nofollow" class="external text" href="https://doi.org/10.1192%2Fapt.bp.113.011296">"A comparison of DSM and ICD classifications of mental disorder"</a>. <i>Advances in Psychiatric Treatment</i>. <b>20</b> (4): 280–285. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1192%2Fapt.bp.113.011296">10.1192/apt.bp.113.011296</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/1355-5146">1355-5146</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Advances+in+Psychiatric+Treatment&rft.atitle=A+comparison+of+DSM+and+ICD+classifications+of+mental+disorder&rft.volume=20&rft.issue=4&rft.pages=280-285&rft.date=2014&rft_id=info%3Adoi%2F10.1192%2Fapt.bp.113.011296&rft.issn=1355-5146&rft.aulast=Tyrer&rft.aufirst=Peter&rft_id=https%3A%2F%2Fdoi.org%2F10.1192%252Fapt.bp.113.011296&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text">In Appendix G: "ICD-9-CM Codes for Selected General Medical Conditions and Medication-Induced Disorders"</span>
</li>
<li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFAmerican_Psychological_Association2009" class="citation journal cs1">American Psychological Association (2009). <a rel="nofollow" class="external text" href="http://www.apa.org/monitor/2009/10/icd-dsm.aspx">"ICD VS. DSM"</a>. <i>Monitor on Psychology</i>. <b>40</b> (9): 63.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Monitor+on+Psychology&rft.atitle=ICD+VS.+DSM&rft.volume=40&rft.issue=9&rft.pages=63&rft.date=2009&rft.au=American+Psychological+Association&rft_id=http%3A%2F%2Fwww.apa.org%2Fmonitor%2F2009%2F10%2Ficd-dsm.aspx&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://www.who.int/entity/classifications/icd/en/GRNBOOK.pdf">Diagnostic criteria for research</a>, p. 213–225 (<a href="/wiki/World_Health_Organization" title="World Health Organization">WHO</a> 1993)</span>
</li>
<li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGorwitz1974" class="citation journal cs1">Gorwitz K (March–April 1974). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1616226">"Census enumeration of the mentally ill and the mentally retarded in the nineteenth century"</a>. <i>Health Services Reports</i>. <b>89</b> (2): 180–187. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2307%2F4595007">10.2307/4595007</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a> <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/4595007">4595007</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1616226">1616226</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/4274650">4274650</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Health+Services+Reports&rft.atitle=Census+enumeration+of+the+mentally+ill+and+the+mentally+retarded+in+the+nineteenth+century&rft.volume=89&rft.issue=2&rft.pages=180-187&rft.date=1974-03%2F1974-04&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1616226%23id-name%3DPMC&rft_id=info%3Apmid%2F4274650&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F4595007%23id-name%3DJSTOR&rft_id=info%3Adoi%2F10.2307%2F4595007&rft.aulast=Gorwitz&rft.aufirst=K&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1616226&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-21">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation journal cs1">"The original thirteen". <i>Hospital & Community Psychiatry</i>. <b>27</b> (7): 464–467. 1976. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0022-1597">0022-1597</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/776775">776775</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Hospital+%26+Community+Psychiatry&rft.atitle=The+original+thirteen&rft.volume=27&rft.issue=7&rft.pages=464-467&rft.date=1976&rft_id=info%3Apmid%2F776775&rft.issn=0022-1597&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-22">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://collections.nlm.nih.gov/catalog/nlm:nlmuid-31910070R-bk">"A nomenclature of diseases: with the reports of the majority and of the minority of the committee thereon: presented to the American Medical Association at the meeting held in Philadelphia, May 1872"</a>. <i>Digital Collections – National Library of Medicine</i>. p. 53<span class="reference-accessdate">. Retrieved <span class="nowrap">November 6,</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Digital+Collections+%E2%80%93+National+Library+of+Medicine&rft.atitle=A+nomenclature+of+diseases%3A+with+the+reports+of+the+majority+and+of+the+minority+of+the+committee+thereon%3A+presented+to+the+American+Medical+Association+at+the+meeting+held+in+Philadelphia%2C+May+1872&rft.pages=53&rft_id=https%3A%2F%2Fcollections.nlm.nih.gov%2Fcatalog%2Fnlm%3Anlmuid-31910070R-bk&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-23"><span class="mw-cite-backlink"><b><a href="#cite_ref-23">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf"><i>History of the Statistical Classification of Diseases and Causes of Death</i></a> <span class="cs1-format">(PDF)</span>. National Centre for Health Statistics. 2011. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110505192204/http://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on May 5, 2011.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=History+of+the+Statistical+Classification+of+Diseases+and+Causes+of+Death&rft.pub=National+Centre+for+Health+Statistics&rft.date=2011&rft_id=https%3A%2F%2Fwww.cdc.gov%2Fnchs%2Fdata%2Fmisc%2Fclassification_diseases2011.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-24"><span class="mw-cite-backlink"><b><a href="#cite_ref-24">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGrob1976" class="citation journal cs1">Grob GN (1976). "Edward Jarvis and the Federal Census: A Chapter in the History of Nineteenth-Century American Medicine". <i>Bulletin of the History of Medicine</i>. <b>50</b> (1). The Johns Hopkins University Press: 4–27. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a> <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/44450311">44450311</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/769874">769874</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Bulletin+of+the+History+of+Medicine&rft.atitle=Edward+Jarvis+and+the+Federal+Census%3A+A+Chapter+in+the+History+of+Nineteenth-Century+American+Medicine&rft.volume=50&rft.issue=1&rft.pages=4-27&rft.date=1976&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F44450311%23id-name%3DJSTOR&rft_id=info%3Apmid%2F769874&rft.aulast=Grob&rft.aufirst=GN&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-25"><span class="mw-cite-backlink"><b><a href="#cite_ref-25">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://sites.google.com/site/psych54000/a">History of the DSM</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130911021653/https://sites.google.com/site/psych54000/a">Archived</a> 2013-09-11 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> Nathaniel Deyoung, Purdue University. Retrieved 9 Sept 2013</span>
</li>
<li id="cite_note-26"><span class="mw-cite-backlink"><b><a href="#cite_ref-26">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBarton1987" class="citation book cs1">Barton WE (1987). <i>The history and influence of the American Psychiatric Association</i>. American Psychiatric Association. Washington, D.C.: American Psychiatric Press. p. 89. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-88048-231-1" title="Special:BookSources/0-88048-231-1"><bdi>0-88048-231-1</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/oclc/13945621">13945621</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+history+and+influence+of+the+American+Psychiatric+Association&rft.place=Washington%2C+D.C.&rft.pages=89&rft.pub=American+Psychiatric+Press&rft.date=1987&rft_id=info%3Aoclcnum%2F13945621&rft.isbn=0-88048-231-1&rft.aulast=Barton&rft.aufirst=WE&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-27">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://archive.org/search.php?query=%28%28subject%3A%22Bertillon%2C%20Jacques%22%20OR%20subject%3A%22Jacques%20Bertillon%22%20OR%20creator%3A%22Bertillon%2C%20Jacques%22%20OR%20creator%3A%22Jacques%20Bertillon%22%20OR%20creator%3A%22Bertillon%2C%20J%2E%22%20OR%20title%3A%22Jacques%20Bertillon%22%20OR%20description%3A%22Bertillon%2C%20Jacques%22%20OR%20description%3A%22Jacques%20Bertillon%22%29%20OR%20%28%221851-1922%22%20AND%20Bertillon%29%29%20AND%20%28-mediatype:software%29">Works of Jacques Bertillon</a>, Internet Archive.</span>
</li>
<li id="cite_note-History-28"><span class="mw-cite-backlink">^ <a href="#cite_ref-History_28-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-History_28-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-History_28-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-History_28-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.who.int/entity/classifications/icd/en/HistoryOfICD.pdf">"<i>History of the development of the ICD</i>"</a> <span class="cs1-format">(PDF)</span>. <i>Who.int</i><span class="reference-accessdate">. Retrieved <span class="nowrap">December 11,</span> 2017</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Who.int&rft.atitle=History+of+the+development+of+the+ICD.&rft_id=https%3A%2F%2Fwww.who.int%2Fentity%2Fclassifications%2Ficd%2Fen%2FHistoryOfICD.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-29">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://wellcomecollection.org/works/u4swa3m3/"><i>The Bellevue Hospital nomenclature of diseases and conditions</i></a> (3rd ed.). New York: Bellvue and Allied Hospitals. 1911.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+Bellevue+Hospital+nomenclature+of+diseases+and+conditions&rft.place=New+York&rft.edition=3rd&rft.pub=Bellvue+and+Allied+Hospitals&rft.date=1911&rft_id=https%3A%2F%2Fwellcomecollection.org%2Fworks%2Fu4swa3m3%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://archive.org/details/statisticalmanu00assogoog">Statistical manual for the use of institutions for the insane (1918)</a> University of Michigan via Internet Archive</span>
</li>
<li id="cite_note-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-31">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFClarkCuthbertLewis-FernándezNarrow2017" class="citation journal cs1">Clark LA, Cuthbert B, Lewis-Fernández R, Narrow WE, Reed GM (September 2017). <a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F1529100617727266">"Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health's Research Domain Criteria (RDoC)"</a>. <i>Psychological Science in the Public Interest</i>. <b>18</b> (2): 72–145. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F1529100617727266">10.1177/1529100617727266</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29211974">29211974</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206743519">206743519</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychological+Science+in+the+Public+Interest&rft.atitle=Three+Approaches+to+Understanding+and+Classifying+Mental+Disorder%3A+ICD-11%2C+DSM-5%2C+and+the+National+Institute+of+Mental+Health%27s+Research+Domain+Criteria+%28RDoC%29&rft.volume=18&rft.issue=2&rft.pages=72-145&rft.date=2017-09&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206743519%23id-name%3DS2CID&rft_id=info%3Apmid%2F29211974&rft_id=info%3Adoi%2F10.1177%2F1529100617727266&rft.aulast=Clark&rft.aufirst=LA&rft.au=Cuthbert%2C+B&rft.au=Lewis-Fern%C3%A1ndez%2C+R&rft.au=Narrow%2C+WE&rft.au=Reed%2C+GM&rft_id=https%3A%2F%2Fdoi.org%2F10.1177%252F1529100617727266&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBarton1987" class="citation book cs1">Barton WE (1987). <i>The history and influence of the American Psychiatric Association</i>. American Psychiatric Association. Washington, D.C.: American Psychiatric Press. p. 168. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-88048-231-1" title="Special:BookSources/0-88048-231-1"><bdi>0-88048-231-1</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/oclc/13945621">13945621</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+history+and+influence+of+the+American+Psychiatric+Association&rft.place=Washington%2C+D.C.&rft.pages=168&rft.pub=American+Psychiatric+Press&rft.date=1987&rft_id=info%3Aoclcnum%2F13945621&rft.isbn=0-88048-231-1&rft.aulast=Barton&rft.aufirst=WE&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:8-33"><span class="mw-cite-backlink">^ <a href="#cite_ref-:8_33-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:8_33-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:8_33-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:8_33-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:8_33-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:8_33-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-:8_33-6"><sup><i><b>g</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://archive.org/details/dsm-1">"DSM-1 Full PDF"</a>. 1952.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=DSM-1+Full+PDF&rft.date=1952&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fdsm-1&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-34">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFLogie1933" class="citation journal cs1">Logie, H. B. (December 1933). <a rel="nofollow" class="external text" href="https://journals.lww.com/jonmd/Citation/1933/12000/A_Standard_Classified_Nomenclature_of_Disease.75.aspx">"A Standard Classified Nomenclature of Disease"</a>. <i>The Journal of Nervous and Mental Disease</i>. <b>78</b> (6): 679. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00005053-193312000-00075">10.1097/00005053-193312000-00075</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0022-3018">0022-3018</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Nervous+and+Mental+Disease&rft.atitle=A+Standard+Classified+Nomenclature+of+Disease&rft.volume=78&rft.issue=6&rft.pages=679&rft.date=1933-12&rft_id=info%3Adoi%2F10.1097%2F00005053-193312000-00075&rft.issn=0022-3018&rft.aulast=Logie&rft.aufirst=H.+B.&rft_id=https%3A%2F%2Fjournals.lww.com%2Fjonmd%2FCitation%2F1933%2F12000%2FA_Standard_Classified_Nomenclature_of_Disease.75.aspx&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-35"><span class="mw-cite-backlink"><b><a href="#cite_ref-35">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGreenbergShumanMeyer2004" class="citation journal cs1">Greenberg SA, Shuman DW, Meyer RG (2004). "Unmasking forensic diagnosis". <i>International Journal of Law and Psychiatry</i>. <b>27</b> (1): 1–15. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ijlp.2004.01.001">10.1016/j.ijlp.2004.01.001</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15019764">15019764</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=International+Journal+of+Law+and+Psychiatry&rft.atitle=Unmasking+forensic+diagnosis&rft.volume=27&rft.issue=1&rft.pages=1-15&rft.date=2004&rft_id=info%3Adoi%2F10.1016%2Fj.ijlp.2004.01.001&rft_id=info%3Apmid%2F15019764&rft.aulast=Greenberg&rft.aufirst=SA&rft.au=Shuman%2C+DW&rft.au=Meyer%2C+RG&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-36"><span class="mw-cite-backlink"><b><a href="#cite_ref-36">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFThompsonHayden1961" class="citation book cs1">Thompson, ET; Hayden, AC, eds. (1961). <i>Standard nomenclature of diseases and operations</i> (5th ed.). New York: McGraw Hill.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Standard+nomenclature+of+diseases+and+operations&rft.place=New+York&rft.edition=5th&rft.pub=McGraw+Hill&rft.date=1961&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-37"><span class="mw-cite-backlink"><b><a href="#cite_ref-37">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://books.google.com/books?id=BHEwAAAAIAAJ"><i>The Medical Department of the United States Army in World War II</i></a>. Office of the Surgeon General, Department of the Army. 1966. p. 756.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+Medical+Department+of+the+United+States+Army+in+World+War+II.&rft.pages=756&rft.pub=Office+of+the+Surgeon+General%2C+Department+of+the+Army&rft.date=1966&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DBHEwAAAAIAAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-NavyPsyc2-38"><span class="mw-cite-backlink">^ <a href="#cite_ref-NavyPsyc2_38-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-NavyPsyc2_38-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSobocinski" class="citation web cs1">Sobocinski A. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200420113904/https://navymedicine.navylive.dodlive.mil/archives/7192">"A Brief History of U.S. Navy Psychiatric Diagnoses, Part II"</a>. <i>Navy Medicine Live</i>. U.S. Navy Bureau of Medicine and Surgery. Archived from <a rel="nofollow" class="external text" href="https://navymedicine.navylive.dodlive.mil/archives/7192">the original</a> on April 20, 2020<span class="reference-accessdate">. Retrieved <span class="nowrap">April 28,</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Navy+Medicine+Live&rft.atitle=A+Brief+History+of+U.S.+Navy+Psychiatric+Diagnoses%2C+Part+II&rft.aulast=Sobocinski&rft.aufirst=A&rft_id=https%3A%2F%2Fnavymedicine.navylive.dodlive.mil%2Farchives%2F7192&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-39"><span class="mw-cite-backlink"><b><a href="#cite_ref-39">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSandisonSpencer1953" class="citation journal cs1">Sandison RA, Spencer AM (1953). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2015553">"Mental Hospital Service"</a>. <i>British Medical Journal</i>. <b>1</b> (4809): 560. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.1.4809.560">10.1136/bmj.1.4809.560</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2015553">2015553</a></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=British+Medical+Journal&rft.atitle=Mental+Hospital+Service&rft.volume=1&rft.issue=4809&rft.pages=560&rft.date=1953&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2015553%23id-name%3DPMC&rft_id=info%3Adoi%2F10.1136%2Fbmj.1.4809.560&rft.aulast=Sandison&rft.aufirst=RA&rft.au=Spencer%2C+AM&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2015553&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Houts2000-40"><span class="mw-cite-backlink">^ <a href="#cite_ref-Houts2000_40-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Houts2000_40-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFHouts2000" class="citation journal cs1">Houts AC (July 2000). <a rel="nofollow" class="external text" href="https://archive.today/20130105054908/http://www3.interscience.wiley.com/journal/72506618/abstract">"Fifty years of psychiatric nomenclature: reflections on the 1943 War Department Technical Bulletin, Medical 203"</a>. <i>Journal of Clinical Psychology</i>. <b>56</b> (7): 935–967. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F1097-4679%28200007%2956%3A7%3C935%3A%3AAID-JCLP11%3E3.0.CO%3B2-8">10.1002/1097-4679(200007)56:7<935::AID-JCLP11>3.0.CO;2-8</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10902952">10902952</a>. Archived from <a rel="nofollow" class="external text" href="http://www3.interscience.wiley.com/journal/72506618/abstract">the original</a> on January 5, 2013.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Clinical+Psychology&rft.atitle=Fifty+years+of+psychiatric+nomenclature%3A+reflections+on+the+1943+War+Department+Technical+Bulletin%2C+Medical+203&rft.volume=56&rft.issue=7&rft.pages=935-967&rft.date=2000-07&rft_id=info%3Adoi%2F10.1002%2F1097-4679%28200007%2956%3A7%3C935%3A%3AAID-JCLP11%3E3.0.CO%3B2-8&rft_id=info%3Apmid%2F10902952&rft.aulast=Houts&rft.aufirst=AC&rft_id=http%3A%2F%2Fwww3.interscience.wiley.com%2Fjournal%2F72506618%2Fabstract&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-41"><span class="mw-cite-backlink"><b><a href="#cite_ref-41">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://onlinelibrary.wiley.com/doi/10.1002/1097-4679(194607)2:3%3C289::AID-JCLP2270020316%3E3.0.CO;2-O">"Nomenclature of psychiatric disorders and reactions"</a>. <i><a href="/wiki/Journal_of_Clinical_Psychology" title="Journal of Clinical Psychology">Journal of Clinical Psychology</a></i>. <b>2</b> (3): 289–296. July 1946. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F1097-4679%28194607%292%3A3%3C289%3A%3AAID-JCLP2270020316%3E3.0.CO%3B2-O">10.1002/1097-4679(194607)2:3<289::AID-JCLP2270020316>3.0.CO;2-O</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20992064">20992064</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Clinical+Psychology&rft.atitle=Nomenclature+of+psychiatric+disorders+and+reactions&rft.volume=2&rft.issue=3&rft.pages=289-296&rft.date=1946-07&rft_id=info%3Adoi%2F10.1002%2F1097-4679%28194607%292%3A3%3C289%3A%3AAID-JCLP2270020316%3E3.0.CO%3B2-O&rft_id=info%3Apmid%2F20992064&rft_id=https%3A%2F%2Fonlinelibrary.wiley.com%2Fdoi%2F10.1002%2F1097-4679%28194607%292%3A3%253C289%3A%3AAID-JCLP2270020316%253E3.0.CO%3B2-O&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-42"><span class="mw-cite-backlink"><b><a href="#cite_ref-42">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFU.S._Army._U.S._Navy._U.S._Air_Force1949" class="citation book cs1">U.S. Army. U.S. Navy. U.S. Air Force (1949). <a rel="nofollow" class="external text" href="http://archive.org/details/NOMENCLATUREANDMETHODOFRECORDINGPSYCHIATRICCONDITIONS"><i>Joint Armed Forces Nomenclature and Method of Recording Psychiatric Conditions</i></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Joint+Armed+Forces+Nomenclature+and+Method+of+Recording+Psychiatric+Conditions&rft.date=1949&rft.au=U.S.+Army.+U.S.+Navy.+U.S.+Air+Force&rft_id=http%3A%2F%2Farchive.org%2Fdetails%2FNOMENCLATUREANDMETHODOFRECORDINGPSYCHIATRICCONDITIONS&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-43"><span class="mw-cite-backlink"><b><a href="#cite_ref-43">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGrob1991" class="citation journal cs1">Grob GN (April 1991). "Origins of DSM-I: a study in appearance and reality". <i>The American Journal of Psychiatry</i>. <b>148</b> (4): 421–431. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.148.4.421">10.1176/ajp.148.4.421</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/2006685">2006685</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=Origins+of+DSM-I%3A+a+study+in+appearance+and+reality&rft.volume=148&rft.issue=4&rft.pages=421-431&rft.date=1991-04&rft_id=info%3Adoi%2F10.1176%2Fajp.148.4.421&rft_id=info%3Apmid%2F2006685&rft.aulast=Grob&rft.aufirst=GN&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Oldham-44"><span class="mw-cite-backlink">^ <a href="#cite_ref-Oldham_44-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Oldham_44-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Oldham_44-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Oldham_44-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Oldham_44-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFOldham2005" class="citation journal cs1">Oldham JM (2005). <a rel="nofollow" class="external text" href="https://archive.today/20120720080755/http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21">"Personality Disorders"</a>. <i>FOCUS</i>. <b>3</b>: 372–382. Archived from <a rel="nofollow" class="external text" href="http://focus.psychiatryonline.org/article.aspx?Volume=3&page=372&journalID=21">the original</a> on July 20, 2012.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=FOCUS&rft.atitle=Personality+Disorders&rft.volume=3&rft.pages=372-382&rft.date=2005&rft.aulast=Oldham&rft.aufirst=JM&rft_id=http%3A%2F%2Ffocus.psychiatryonline.org%2Farticle.aspx%3FVolume%3D3%26page%3D372%26journalID%3D21&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:9-45"><span class="mw-cite-backlink">^ <a href="#cite_ref-:9_45-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:9_45-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:9_45-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:9_45-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:9_45-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf">"Diagnostic and Statistical Manual"</a> <span class="cs1-format">(PDF)</span>. <i>American Psychiatric Association</i>. The Committee on Nomenclature and Statistics. 1952<span class="reference-accessdate">. Retrieved <span class="nowrap">April 25,</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=American+Psychiatric+Association&rft.atitle=Diagnostic+and+Statistical+Manual&rft.date=1952&rft_id=http%3A%2F%2Fwww.turkpsikiyatri.org%2Farsiv%2Fdsm-1952.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:0-46"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_46-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_46-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFEdsall2003" class="citation book cs1">Edsall NC (2003). <i>Toward Stonewall: Homosexuality and Society in the Modern Western World</i>. University of Virginia Press.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Toward+Stonewall%3A+Homosexuality+and+Society+in+the+Modern+Western+World&rft.pub=University+of+Virginia+Press&rft.date=2003&rft.aulast=Edsall&rft.aufirst=NC&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-47"><span class="mw-cite-backlink"><b><a href="#cite_ref-47">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMarcus2009" class="citation book cs1">Marcus E (2009). <i>Making Gay History</i>. Print: Harper Collins. pp. 58–59.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Making+Gay+History&rft.place=Print&rft.pages=58-59&rft.pub=Harper+Collins&rft.date=2009&rft.aulast=Marcus&rft.aufirst=E&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-48"><span class="mw-cite-backlink"><b><a href="#cite_ref-48">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMayesBagwellErkulwater2009" class="citation book cs1">Mayes R, Bagwell C, Erkulwater JL (2009). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=drBejRLWkHkC&pg=PA76">"The Transformation of Mental Disorders in the 1980s: The DSM-III, Managed Care, and "Cosmetic Psychopharmacology"<span class="cs1-kern-right"></span>"</a>. <i>Medicating Children: ADHD and Pediatric Mental Health</i>. Harvard University Press. p. 76. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-674-03163-0" title="Special:BookSources/978-0-674-03163-0"><bdi>978-0-674-03163-0</bdi></a><span class="reference-accessdate">. Retrieved <span class="nowrap">December 3,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=The+Transformation+of+Mental+Disorders+in+the+1980s%3A+The+DSM-III%2C+Managed+Care%2C+and+%22Cosmetic+Psychopharmacology%22&rft.btitle=Medicating+Children%3A+ADHD+and+Pediatric+Mental+Health&rft.pages=76&rft.pub=Harvard+University+Press&rft.date=2009&rft.isbn=978-0-674-03163-0&rft.aulast=Mayes&rft.aufirst=R&rft.au=Bagwell%2C+C&rft.au=Erkulwater%2C+JL&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DdrBejRLWkHkC%26pg%3DPA76&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Revolution-49"><span class="mw-cite-backlink">^ <a href="#cite_ref-Revolution_49-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Revolution_49-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Revolution_49-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Revolution_49-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMayesHorwitz2005" class="citation journal cs1">Mayes R, Horwitz AV (2005). "DSM-III and the revolution in the classification of mental illness". <i>Journal of the History of the Behavioral Sciences</i>. <b>41</b> (3): 249–267. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fjhbs.20103">10.1002/jhbs.20103</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15981242">15981242</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+History+of+the+Behavioral+Sciences&rft.atitle=DSM-III+and+the+revolution+in+the+classification+of+mental+illness&rft.volume=41&rft.issue=3&rft.pages=249-267&rft.date=2005&rft_id=info%3Adoi%2F10.1002%2Fjhbs.20103&rft_id=info%3Apmid%2F15981242&rft.aulast=Mayes&rft.aufirst=R&rft.au=Horwitz%2C+AV&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Transformation-50"><span class="mw-cite-backlink">^ <a href="#cite_ref-Transformation_50-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Transformation_50-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFWilson1993" class="citation journal cs1">Wilson M (March 1993). "DSM-III and the transformation of American psychiatry: a history". <i>The American Journal of Psychiatry</i>. <b>150</b> (3): 399–410. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.150.3.399">10.1176/ajp.150.3.399</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/8434655">8434655</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=DSM-III+and+the+transformation+of+American+psychiatry%3A+a+history&rft.volume=150&rft.issue=3&rft.pages=399-410&rft.date=1993-03&rft_id=info%3Adoi%2F10.1176%2Fajp.150.3.399&rft_id=info%3Apmid%2F8434655&rft.aulast=Wilson&rft.aufirst=M&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Stuart_A,_Kirk_&_Herb_Kutchins_1994-51"><span class="mw-cite-backlink">^ <a href="#cite_ref-Stuart_A,_Kirk_&_Herb_Kutchins_1994_51-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Stuart_A,_Kirk_&_Herb_Kutchins_1994_51-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKirkKutchins1994" class="citation web cs1">Kirk SA, Kutchins H (1994). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk%26kutchins.htm">"The Myth of the Reliability of DSM"</a>. <i>Journal of Mind and Behavior, 15 (1&2)</i>. Archived from <a rel="nofollow" class="external text" href="http://www.academyanalyticarts.org/kirk&kutchins.htm">the original</a> on March 7, 2008.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Journal+of+Mind+and+Behavior%2C+15+%281%262%29&rft.atitle=The+Myth+of+the+Reliability+of+DSM&rft.date=1994&rft.aulast=Kirk&rft.aufirst=SA&rft.au=Kutchins%2C+H&rft_id=http%3A%2F%2Fwww.academyanalyticarts.org%2Fkirk%26kutchins.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-SpitzerFleiss1974-52"><span class="mw-cite-backlink"><b><a href="#cite_ref-SpitzerFleiss1974_52-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpitzerFleiss1974" class="citation journal cs1">Spitzer RL, Fleiss JL (October 1974). "A re-analysis of the reliability of psychiatric diagnosis". <i>The British Journal of Psychiatry</i>. <b>125</b> (587): 341–347. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1192%2Fbjp.125.4.341">10.1192/bjp.125.4.341</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/4425771">4425771</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:37782257">37782257</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+British+Journal+of+Psychiatry&rft.atitle=A+re-analysis+of+the+reliability+of+psychiatric+diagnosis&rft.volume=125&rft.issue=587&rft.pages=341-347&rft.date=1974-10&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A37782257%23id-name%3DS2CID&rft_id=info%3Apmid%2F4425771&rft_id=info%3Adoi%2F10.1192%2Fbjp.125.4.341&rft.aulast=Spitzer&rft.aufirst=RL&rft.au=Fleiss%2C+JL&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Kirk_&_Kutchins-53"><span class="mw-cite-backlink"><b><a href="#cite_ref-Kirk_&_Kutchins_53-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKirkKutchins1994" class="citation journal cs1">Kirk SA, Kutchins H (1994). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20080307115815/http://www.academyanalyticarts.org/kirk%26kutchins.htm">"The Myth of the Reliability of DSM"</a>. <i>Journal of Mind and Behavior</i>. <b>15</b> (1&2): 71–86. Archived from <a rel="nofollow" class="external text" href="http://www.academyanalyticarts.org/kirk&kutchins.htm">the original</a> on March 7, 2008<span class="reference-accessdate">. Retrieved <span class="nowrap">March 4,</span> 2008</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Mind+and+Behavior&rft.atitle=The+Myth+of+the+Reliability+of+DSM&rft.volume=15&rft.issue=1%262&rft.pages=71-86&rft.date=1994&rft.aulast=Kirk&rft.aufirst=SA&rft.au=Kutchins%2C+H&rft_id=http%3A%2F%2Fwww.academyanalyticarts.org%2Fkirk%26kutchins.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-54"><span class="mw-cite-backlink"><b><a href="#cite_ref-54">^</a></b></span> <span class="reference-text">Bayer, Ronald (1981). <a rel="nofollow" class="external text" href="https://archive.org/details/homosexualityame00bayerich"><i>Homosexuality and American Psychiatry: The Politics of Diagnosis</i></a> Princeton University Press p. 105.</span>
</li>
<li id="cite_note-55"><span class="mw-cite-backlink"><b><a href="#cite_ref-55">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMcCommon2006" class="citation journal cs1">McCommon B (December 2006). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20070810054520/http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809">"Antipsychiatry and the gay rights movement"</a>. <i>Psychiatric Services</i>. <b>57</b> (12): 1809, author reply 1809–1809, author reply 1810. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ps.57.12.1809">10.1176/appi.ps.57.12.1809</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17158503">17158503</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:37419476">37419476</a>. Archived from <a rel="nofollow" class="external text" href="http://psychservices.psychiatryonline.org/cgi/content/full/57/12/1809">the original</a> on August 10, 2007.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychiatric+Services&rft.atitle=Antipsychiatry+and+the+gay+rights+movement&rft.volume=57&rft.issue=12&rft.pages=1809%2C+author+reply+1809-1809%2C+author+reply+1810&rft.date=2006-12&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A37419476%23id-name%3DS2CID&rft_id=info%3Apmid%2F17158503&rft_id=info%3Adoi%2F10.1176%2Fappi.ps.57.12.1809&rft.aulast=McCommon&rft.aufirst=B&rft_id=http%3A%2F%2Fpsychservices.psychiatryonline.org%2Fcgi%2Fcontent%2Ffull%2F57%2F12%2F1809&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-56"><span class="mw-cite-backlink"><b><a href="#cite_ref-56">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFRissmillerRissmiller2006" class="citation journal cs1">Rissmiller DJ, Rissmiller J (2006). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20070630022511/http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a">"Letter in reply"</a>. <i>Psychiatr Serv</i>. <b>57</b> (12): 1809–1810. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ps.57.12.1809-a">10.1176/appi.ps.57.12.1809-a</a>. Archived from <a rel="nofollow" class="external text" href="http://ps.psychiatryonline.org/cgi/content/full/57/12/1809-a">the original</a> on June 30, 2007.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychiatr+Serv&rft.atitle=Letter+in+reply&rft.volume=57&rft.issue=12&rft.pages=1809-1810&rft.date=2006&rft_id=info%3Adoi%2F10.1176%2Fappi.ps.57.12.1809-a&rft.aulast=Rissmiller&rft.aufirst=DJ&rft.au=Rissmiller%2C+J&rft_id=http%3A%2F%2Fps.psychiatryonline.org%2Fcgi%2Fcontent%2Ffull%2F57%2F12%2F1809-a&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-58"><span class="mw-cite-backlink"><b><a href="#cite_ref-58">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpitzer1981" class="citation journal cs1">Spitzer RL (February 1981). "The diagnostic status of homosexuality in DSM-III: a reformulation of the issues". <i>The American Journal of Psychiatry</i>. <b>138</b> (2): 210–215. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.138.2.210">10.1176/ajp.138.2.210</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/7457641">7457641</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=The+diagnostic+status+of+homosexuality+in+DSM-III%3A+a+reformulation+of+the+issues&rft.volume=138&rft.issue=2&rft.pages=210-215&rft.date=1981-02&rft_id=info%3Adoi%2F10.1176%2Fajp.138.2.210&rft_id=info%3Apmid%2F7457641&rft.aulast=Spitzer&rft.aufirst=RL&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-59"><span class="mw-cite-backlink"><b><a href="#cite_ref-59">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://pages.uoregon.edu/eherman/teaching/texts/DSM-II_Homosexuality_Revision.pdf">Homosexuality and sexuality orientation disturbance: Proposed change in DSM-II, 6th printing, page 44. Position Statement (Retired)</a>. APA Document Reference No. 730008. Arlington, VA: American Psychiatric Association, 1973. ("Since the last printing of this Manual, the trustees of the American Psychiatric Association, in December 1973, voted to eliminate Homosexuality per se as a mental disorder and to substitute therefor a new category titled Sexual Orientation Disturbance. The change appears on page 44 of this, the seventh printing.").</span>
</li>
<li id="cite_note-Coolidge_and_Segal_1998-60"><span class="mw-cite-backlink"><b><a href="#cite_ref-Coolidge_and_Segal_1998_60-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCoolidgeSegal1998" class="citation journal cs1">Coolidge, Frederick L.; Segal, Daniel L. (August 1998). <a rel="nofollow" class="external text" href="https://www.sciencedirect.com/science/article/abs/pii/S0272735898000026">"Evolution of personality disorder diagnosis in the Diagnostic and statistical manual of mental disorders"</a>. <i>Clinical Psychology Review</i>. <b>18</b> (5): 585–599. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0272-7358%2898%2900002-6">10.1016/s0272-7358(98)00002-6</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9740979">9740979</a><span class="reference-accessdate">. Retrieved <span class="nowrap">September 27,</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Psychology+Review&rft.atitle=Evolution+of+personality+disorder+diagnosis+in+the+Diagnostic+and+statistical+manual+of+mental+disorders&rft.volume=18&rft.issue=5&rft.pages=585-599&rft.date=1998-08&rft_id=info%3Adoi%2F10.1016%2Fs0272-7358%2898%2900002-6&rft_id=info%3Apmid%2F9740979&rft.aulast=Coolidge&rft.aufirst=Frederick+L.&rft.au=Segal%2C+Daniel+L.&rft_id=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fabs%2Fpii%2FS0272735898000026&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-61"><span class="mw-cite-backlink"><b><a href="#cite_ref-61">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpiegel2005" class="citation magazine cs1">Spiegel A (January 3, 2005). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20061212180933/http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact">"The Dictionary of Disorder: How one man revolutionized psychiatry"</a>. <i>The New Yorker</i>. Archived from <a rel="nofollow" class="external text" href="http://www.newyorker.com/fact/content/articles/050103fa_fact?050103fa_fact">the original</a> on December 12, 2006.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+Yorker&rft.atitle=The+Dictionary+of+Disorder%3A+How+one+man+revolutionized+psychiatry&rft.date=2005-01-03&rft.aulast=Spiegel&rft.aufirst=A&rft_id=http%3A%2F%2Fwww.newyorker.com%2Ffact%2Fcontent%2Farticles%2F050103fa_fact%3F050103fa_fact&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-PMID5774702-62"><span class="mw-cite-backlink"><b><a href="#cite_ref-PMID5774702_62-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCooperKendellGurlandSartorius1969" class="citation journal cs1 cs1-prop-long-vol">Cooper JE, Kendell RE, Gurland BJ, Sartorius N, Farkas T (April 1969). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20100824224731/http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30">"Cross-national study of diagnosis of the mental disorders: some results from the first comparative investigation"</a>. <i>The American Journal of Psychiatry</i>. 10 Suppl (10 Suppl): 21–29. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.125.10s.21">10.1176/ajp.125.10s.21</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/5774702">5774702</a>. Archived from <a rel="nofollow" class="external text" href="http://ajp.psychiatryonline.org/cgi/reprint/125/10S/30">the original</a> on August 24, 2010.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=Cross-national+study+of+diagnosis+of+the+mental+disorders%3A+some+results+from+the+first+comparative+investigation&rft.volume=10+Suppl&rft.issue=10+Suppl&rft.pages=21-29&rft.date=1969-04&rft_id=info%3Adoi%2F10.1176%2Fajp.125.10s.21&rft_id=info%3Apmid%2F5774702&rft.aulast=Cooper&rft.aufirst=JE&rft.au=Kendell%2C+RE&rft.au=Gurland%2C+BJ&rft.au=Sartorius%2C+N&rft.au=Farkas%2C+T&rft_id=http%3A%2F%2Fajp.psychiatryonline.org%2Fcgi%2Freprint%2F125%2F10S%2F30&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-63"><span class="mw-cite-backlink"><b><a href="#cite_ref-63">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFDecker2013" class="citation book cs1">Decker, Hannah S. (2013). <i>The making of DSM-III®: a diagnostic manual's conquest of American psychiatry</i>. Oxford New York Auckland: Oxford University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9780195382235" title="Special:BookSources/9780195382235"><bdi>9780195382235</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+making+of+DSM-III%C2%AE%3A+a+diagnostic+manual%27s+conquest+of+American+psychiatry&rft.place=Oxford+New+York+Auckland&rft.pub=Oxford+University+Press&rft.date=2013&rft.isbn=9780195382235&rft.aulast=Decker&rft.aufirst=Hannah+S.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Decker_(2013)-64"><span class="mw-cite-backlink"><b><a href="#cite_ref-Decker_(2013)_64-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFDecker2013" class="citation book cs1">Decker, Hannah S. (2013). <i>The making of DSM-III®: a diagnostic manual's conquest of American psychiatry</i>. Oxford New York Auckland: Oxford University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9780195382235" title="Special:BookSources/9780195382235"><bdi>9780195382235</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+making+of+DSM-III%C2%AE%3A+a+diagnostic+manual%27s+conquest+of+American+psychiatry&rft.place=Oxford+New+York+Auckland&rft.pub=Oxford+University+Press&rft.date=2013&rft.isbn=9780195382235&rft.aulast=Decker&rft.aufirst=Hannah+S.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-65"><span class="mw-cite-backlink"><b><a href="#cite_ref-65">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFLane2007" class="citation book cs1">Lane C (2007). <span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/shynesshownormal00lane/page/263"><i>Shyness: How Normal Behavior Became a Sickness</i></a></span>. Yale University Press. p. <a rel="nofollow" class="external text" href="https://archive.org/details/shynesshownormal00lane/page/263">263</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-300-12446-0" title="Special:BookSources/978-0-300-12446-0"><bdi>978-0-300-12446-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Shyness%3A+How+Normal+Behavior+Became+a+Sickness&rft.pages=263&rft.pub=Yale+University+Press&rft.date=2007&rft.isbn=978-0-300-12446-0&rft.aulast=Lane&rft.aufirst=C&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fshynesshownormal00lane%2Fpage%2F263&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-66"><span class="mw-cite-backlink"><b><a href="#cite_ref-66">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><i>Diagnostic and statistical manual of mental disorders</i> (3rd ed.). Washington, DC: American Psychiatric Association. 1980.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Diagnostic+and+statistical+manual+of+mental+disorders&rft.place=Washington%2C+DC&rft.edition=3rd&rft.pub=American+Psychiatric+Association&rft.date=1980&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Need-67"><span class="mw-cite-backlink"><b><a href="#cite_ref-Need_67-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFButlerHutchinson2020" class="citation journal cs1">Butler, Catherine; Hutchinson, Anna (2020). <a rel="nofollow" class="external text" href="https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf">"Debate: The pressing need for research and services for gender desisters/Detransitioners"</a> <span class="cs1-format">(PDF)</span>. <i>Child and Adolescent Mental Health</i>. <b>25</b> (1): 45–47. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fcamh.12361">10.1111/camh.12361</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32285632">32285632</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:210484832">210484832</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20221128201913/https://purehost.bath.ac.uk/ws/files/201923425/Desister_paperfinal.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on November 28, 2022.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Child+and+Adolescent+Mental+Health&rft.atitle=Debate%3A+The+pressing+need+for+research+and+services+for+gender+desisters%2FDetransitioners&rft.volume=25&rft.issue=1&rft.pages=45-47&rft.date=2020&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A210484832%23id-name%3DS2CID&rft_id=info%3Apmid%2F32285632&rft_id=info%3Adoi%2F10.1111%2Fcamh.12361&rft.aulast=Butler&rft.aufirst=Catherine&rft.au=Hutchinson%2C+Anna&rft_id=https%3A%2F%2Fpurehost.bath.ac.uk%2Fws%2Ffiles%2F201923425%2FDesister_paperfinal.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-68"><span class="mw-cite-backlink"><b><a href="#cite_ref-68">^</a></b></span> <span class="reference-text">American Psychological Association. (2013). <i>Highlights of Changes from DSM-IV-TR to DSM-5</i> [Fact sheet]. <a rel="nofollow" class="external free" href="https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf">https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf</a></span>
</li>
<li id="cite_note-69"><span class="mw-cite-backlink"><b><a href="#cite_ref-69">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpiegelGlass2002" class="citation web cs1">Spiegel A, Glass I (January 18, 2002). <a rel="nofollow" class="external text" href="http://www.thisamericanlife.org/radio-archives/episode/204/81-words">"81 Words"</a>. <i>This American Life</i>. Chicago: WBEZ Chicago Public Radio.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=This+American+Life&rft.atitle=81+Words&rft.date=2002-01-18&rft.aulast=Spiegel&rft.aufirst=A&rft.au=Glass%2C+I&rft_id=http%3A%2F%2Fwww.thisamericanlife.org%2Fradio-archives%2Fepisode%2F204%2F81-words&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-70"><span class="mw-cite-backlink"><b><a href="#cite_ref-70">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFrancesMackRossFirst2000" class="citation book cs1">Frances A, Mack AH, Ross R, First MB (2000) [1995]. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20070323150804/http://www.acnp.org/G4/GN401000082/CH081.html">"The DSM-IV Classification and Psychopharmacology"</a>. In Bloom FE, Kupfer DJ (eds.). <i>Psychopharmacology: The Fourth Generation of Progress</i>. American College of Neuropsychopharmacology. Archived from <a rel="nofollow" class="external text" href="http://www.acnp.org/G4/GN401000082/CH081.html">the original</a> on March 23, 2007<span class="reference-accessdate">. Retrieved <span class="nowrap">February 28,</span> 2007</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=The+DSM-IV+Classification+and+Psychopharmacology&rft.btitle=Psychopharmacology%3A+The+Fourth+Generation+of+Progress&rft.pub=American+College+of+Neuropsychopharmacology&rft.date=2000&rft.aulast=Frances&rft.aufirst=A&rft.au=Mack%2C+AH&rft.au=Ross%2C+R&rft.au=First%2C+MB&rft_id=http%3A%2F%2Fwww.acnp.org%2FG4%2FGN401000082%2FCH081.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-71"><span class="mw-cite-backlink"><b><a href="#cite_ref-71">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFShaffer1996" class="citation journal cs1">Shaffer D (August 1996). "A participant's observations: preparing DSM-IV". <i>Canadian Journal of Psychiatry</i>. <b>41</b> (6): 325–329. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F070674379604100602">10.1177/070674379604100602</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/8862851">8862851</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:28547523">28547523</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Canadian+Journal+of+Psychiatry&rft.atitle=A+participant%27s+observations%3A+preparing+DSM-IV&rft.volume=41&rft.issue=6&rft.pages=325-329&rft.date=1996-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A28547523%23id-name%3DS2CID&rft_id=info%3Apmid%2F8862851&rft_id=info%3Adoi%2F10.1177%2F070674379604100602&rft.aulast=Shaffer&rft.aufirst=D&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-72"><span class="mw-cite-backlink"><b><a href="#cite_ref-72">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMaisel2013" class="citation web cs1">Maisel ER (July 23, 2013). <a rel="nofollow" class="external text" href="https://www.psychologytoday.com/us/blog/rethinking-mental-health/201307/the-new-definition-mental-disorder">"The New Definition of a Mental Disorder"</a>. <i>Psychology Today</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Psychology+Today&rft.atitle=The+New+Definition+of+a+Mental+Disorder&rft.date=2013-07-23&rft.aulast=Maisel&rft.aufirst=ER&rft_id=https%3A%2F%2Fwww.psychologytoday.com%2Fus%2Fblog%2Frethinking-mental-health%2F201307%2Fthe-new-definition-mental-disorder&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-pmid20624327-73"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid20624327_73-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSteinPhillipsBoltonFulford2010" class="citation journal cs1">Stein DJ, Phillips KA, Bolton D, Fulford KW, Sadler JZ, Kendler KS (November 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101504">"What is a mental/psychiatric disorder? From DSM-IV to DSM-V"</a>. <i>Psychological Medicine</i>. <b>40</b> (11): 1759–1765. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1017%2FS0033291709992261">10.1017/S0033291709992261</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101504">3101504</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20624327">20624327</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychological+Medicine&rft.atitle=What+is+a+mental%2Fpsychiatric+disorder%3F+From+DSM-IV+to+DSM-V&rft.volume=40&rft.issue=11&rft.pages=1759-1765&rft.date=2010-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3101504%23id-name%3DPMC&rft_id=info%3Apmid%2F20624327&rft_id=info%3Adoi%2F10.1017%2FS0033291709992261&rft.aulast=Stein&rft.aufirst=DJ&rft.au=Phillips%2C+KA&rft.au=Bolton%2C+D&rft.au=Fulford%2C+KW&rft.au=Sadler%2C+JZ&rft.au=Kendler%2C+KS&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3101504&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-74"><span class="mw-cite-backlink"><b><a href="#cite_ref-74">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMaserPatterson2002" class="citation journal cs1">Maser JD, Patterson T (December 2002). "Spectrum and nosology: implications for DSM-V". <i>The Psychiatric Clinics of North America</i>. <b>25</b> (4): 855–885. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0193-953x%2802%2900022-9">10.1016/s0193-953x(02)00022-9</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12462864">12462864</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Psychiatric+Clinics+of+North+America&rft.atitle=Spectrum+and+nosology%3A+implications+for+DSM-V&rft.volume=25&rft.issue=4&rft.pages=855-885&rft.date=2002-12&rft_id=info%3Adoi%2F10.1016%2Fs0193-953x%2802%2900022-9&rft_id=info%3Apmid%2F12462864&rft.aulast=Maser&rft.aufirst=JD&rft.au=Patterson%2C+T&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-75"><span class="mw-cite-backlink"><b><a href="#cite_ref-75">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/books/NBK519711/"><i>DSM-IV to DSM-5 Changes: Overview</i></a>. Internet: Substance Abuse and Mental Health Services Administration. 2016. pp. DSM-5 Changes: Implications for Child Serious Emotional Disturbance.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=DSM-IV+to+DSM-5+Changes%3A+Overview&rft.place=Internet&rft.pages=DSM-5+Changes%3A+Implications+for+Child+Serious+Emotional+Disturbance&rft.pub=Substance+Abuse+and+Mental+Health+Services+Administration&rft.date=2016&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fbooks%2FNBK519711%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-76"><span class="mw-cite-backlink"><b><a href="#cite_ref-76">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/dsmivsourcebook0000unse"><i>DSM-IV Sourcebook</i></a></span>. Vol. 1. Washington, DC: American Psychiatric Association. 1994. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-89042-065-2" title="Special:BookSources/978-0-89042-065-2"><bdi>978-0-89042-065-2</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=DSM-IV+Sourcebook&rft.place=Washington%2C+DC&rft.pub=American+Psychiatric+Association&rft.date=1994&rft.isbn=978-0-89042-065-2&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fdsmivsourcebook0000unse&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-77"><span class="mw-cite-backlink"><b><a href="#cite_ref-77">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/dsmivsourcebook0000unse"><i>DSM-IV Sourcebook</i></a></span>. Vol. 2. Washington, DC: American Psychiatric Association. 1996. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-89042-069-0" title="Special:BookSources/978-0-89042-069-0"><bdi>978-0-89042-069-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=DSM-IV+Sourcebook&rft.place=Washington%2C+DC&rft.pub=American+Psychiatric+Association&rft.date=1996&rft.isbn=978-0-89042-069-0&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fdsmivsourcebook0000unse&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-78"><span class="mw-cite-backlink"><b><a href="#cite_ref-78">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation book cs1"><span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/dsmivsourcebook0000unse"><i>DSM-IV Sourcebook</i></a></span>. Vol. 3. Washington, DC: American Psychiatric Association. 1997. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-89042-073-7" title="Special:BookSources/978-0-89042-073-7"><bdi>978-0-89042-073-7</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=DSM-IV+Sourcebook&rft.place=Washington%2C+DC&rft.pub=American+Psychiatric+Association&rft.date=1997&rft.isbn=978-0-89042-073-7&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fdsmivsourcebook0000unse&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-79"><span class="mw-cite-backlink"><b><a href="#cite_ref-79">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSadock1999" class="citation journal cs1">Sadock BJ (October 1999). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20131206233357/http://ajp.psychiatryonline.org/article.aspx?articleid=173760">"DSM-IV Sourcebook, vol. 4 (Book Forum: Assessment and Diagnosis)"</a>. <i>American Journal of Psychiatry</i>. <b>156</b> (10): 1655. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.156.10.1655">10.1176/ajp.156.10.1655</a>. Archived from <a rel="nofollow" class="external text" href="http://ajp.psychiatryonline.org/article.aspx?articleid=173760">the original</a> on December 6, 2013<span class="reference-accessdate">. Retrieved <span class="nowrap">December 3,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Journal+of+Psychiatry&rft.atitle=DSM-IV+Sourcebook%2C+vol.+4+%28Book+Forum%3A+Assessment+and+Diagnosis%29&rft.volume=156&rft.issue=10&rft.pages=1655&rft.date=1999-10&rft_id=info%3Adoi%2F10.1176%2Fajp.156.10.1655&rft.aulast=Sadock&rft.aufirst=BJ&rft_id=http%3A%2F%2Fajp.psychiatryonline.org%2Farticle.aspx%3Farticleid%3D173760&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Poland01vol1-80"><span class="mw-cite-backlink"><b><a href="#cite_ref-Poland01vol1_80-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFPoland2001" class="citation book cs1">Poland JS (2001). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20050501182254/http://mentalhelp.net/books/books.php?type=de&id=557"><i>Review of Volume 1 of DSM-IV sourcebook</i></a>. Archived from <a rel="nofollow" class="external text" href="http://mentalhelp.net/books/books.php?type=de&id=557">the original</a> on May 1, 2005.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Review+of+Volume+1+of+DSM-IV+sourcebook&rft.date=2001&rft.aulast=Poland&rft.aufirst=JS&rft_id=http%3A%2F%2Fmentalhelp.net%2Fbooks%2Fbooks.php%3Ftype%3Dde%26id%3D557&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Poland01vol2-81"><span class="mw-cite-backlink"><b><a href="#cite_ref-Poland01vol2_81-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFPoland2001" class="citation book cs1">Poland JS (2001). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20070927005022/http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74"><i>Review of vol 2 of DSM-IV sourcebook</i></a>. Archived from <a rel="nofollow" class="external text" href="http://mentalhelp.net/poc/view_doc.php?id=996&type=book&cn=74">the original</a> on September 27, 2007.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Review+of+vol+2+of+DSM-IV+sourcebook&rft.date=2001&rft.aulast=Poland&rft.aufirst=JS&rft_id=http%3A%2F%2Fmentalhelp.net%2Fpoc%2Fview_doc.php%3Fid%3D996%26type%3Dbook%26cn%3D74&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-82"><span class="mw-cite-backlink"><b><a href="#cite_ref-82">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://behavenet.com/dsm-iv-replaced-dsm-iv-tr-changes-diagnostic-criteria">"DSM-IV replaced by DSM-IV-TR: changes in diagnostic criteria"</a>. <i>Behavenet</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Behavenet&rft.atitle=DSM-IV+replaced+by+DSM-IV-TR%3A+changes+in+diagnostic+criteria&rft_id=https%3A%2F%2Fbehavenet.com%2Fdsm-iv-replaced-dsm-iv-tr-changes-diagnostic-criteria&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-pmid11875221-83"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid11875221_83-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFirstPincus2002" class="citation journal cs1">First MB, Pincus HA (March 2002). "The DSM-IV Text Revision: rationale and potential impact on clinical practice". <i>Psychiatric Services</i>. <b>53</b> (3): 288–292. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ps.53.3.288">10.1176/appi.ps.53.3.288</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11875221">11875221</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychiatric+Services&rft.atitle=The+DSM-IV+Text+Revision%3A+rationale+and+potential+impact+on+clinical+practice&rft.volume=53&rft.issue=3&rft.pages=288-292&rft.date=2002-03&rft_id=info%3Adoi%2F10.1176%2Fappi.ps.53.3.288&rft_id=info%3Apmid%2F11875221&rft.aulast=First&rft.aufirst=MB&rft.au=Pincus%2C+HA&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-84"><span class="mw-cite-backlink"><b><a href="#cite_ref-84">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCassels2012" class="citation news cs1">Cassels C (December 2, 2012). <a rel="nofollow" class="external text" href="http://www.medscape.com/viewarticle/775496">"DSM-5 Gets APA's Official Stamp of Approval"</a>. <i>Medscape</i>. WebMD, LLC<span class="reference-accessdate">. Retrieved <span class="nowrap">December 5,</span> 2012</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medscape&rft.atitle=DSM-5+Gets+APA%27s+Official+Stamp+of+Approval&rft.date=2012-12-02&rft.aulast=Cassels&rft.aufirst=C&rft_id=http%3A%2F%2Fwww.medscape.com%2Fviewarticle%2F775496&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-85"><span class="mw-cite-backlink"><b><a href="#cite_ref-85">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKinderman2013" class="citation web cs1">Kinderman P (May 20, 2013). <a rel="nofollow" class="external text" href="https://theconversation.com/explainer-what-is-the-dsm-14127">"Explainer: what is the DSM?"</a>. <i>The Conversation Australia</i>. The Conversation Media Group<span class="reference-accessdate">. Retrieved <span class="nowrap">May 21,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=The+Conversation+Australia&rft.atitle=Explainer%3A+what+is+the+DSM%3F&rft.date=2013-05-20&rft.aulast=Kinderman&rft.aufirst=P&rft_id=http%3A%2F%2Ftheconversation.com%2Fexplainer-what-is-the-dsm-14127&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-86"><span class="mw-cite-backlink"><b><a href="#cite_ref-86">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFJayson2013" class="citation news cs1">Jayson S (May 12, 2013). <a rel="nofollow" class="external text" href="https://www.usatoday.com/story/news/nation/2013/05/12/dsm-psychiatry-mental-disorders/2150819/">"Books blast new version of psychiatry's bible, the DSM"</a>. <i>USA Today</i><span class="reference-accessdate">. Retrieved <span class="nowrap">May 21,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=USA+Today&rft.atitle=Books+blast+new+version+of+psychiatry%27s+bible%2C+the+DSM&rft.date=2013-05-12&rft.aulast=Jayson&rft.aufirst=S&rft_id=https%3A%2F%2Fwww.usatoday.com%2Fstory%2Fnews%2Fnation%2F2013%2F05%2F12%2Fdsm-psychiatry-mental-disorders%2F2150819%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-87"><span class="mw-cite-backlink"><b><a href="#cite_ref-87">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFPearson2013" class="citation news cs1">Pearson C (May 20, 2013). <a rel="nofollow" class="external text" href="http://www.huffingtonpost.com/2013/05/20/dsm5-changes-what-parents-need-to-know_n_3294413.html">"DSM-5 Changes: What Parents Need To Know About The First Major Revision In Nearly 20 Years"</a>. <i>The Huffington Post</i><span class="reference-accessdate">. Retrieved <span class="nowrap">May 21,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Huffington+Post&rft.atitle=DSM-5+Changes%3A+What+Parents+Need+To+Know+About+The+First+Major+Revision+In+Nearly+20+Years&rft.date=2013-05-20&rft.aulast=Pearson&rft.aufirst=C&rft_id=http%3A%2F%2Fwww.huffingtonpost.com%2F2013%2F05%2F20%2Fdsm5-changes-what-parents-need-to-know_n_3294413.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-titleTrademark'''_Electronic_Search_System_(TESS)-88"><span class="mw-cite-backlink"><b><a href="#cite_ref-titleTrademark'''_Electronic_Search_System_(TESS)_88-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://tess2.uspto.gov/">"Trademark Electronic Search System (TESS)"</a><span class="reference-accessdate">. Retrieved <span class="nowrap">February 3,</span> 2010</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Trademark+Electronic+Search+System+%28TESS%29&rft_id=http%3A%2F%2Ftess2.uspto.gov%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-89"><span class="mw-cite-backlink"><b><a href="#cite_ref-89">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20150226050453/http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf">"Highlights of Changes from DSM-IV-TR to DSM-5"</a> <span class="cs1-format">(PDF)</span>. <i>American Psychiatric Association</i>. May 17, 2013. Archived from <a rel="nofollow" class="external text" href="http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf">the original</a> <span class="cs1-format">(PDF)</span> on February 26, 2015<span class="reference-accessdate">. Retrieved <span class="nowrap">January 4,</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=American+Psychiatric+Association&rft.atitle=Highlights+of+Changes+from+DSM-IV-TR+to+DSM-5&rft.date=2013-05-17&rft_id=http%3A%2F%2Fwww.psychiatry.org%2FFile%2520Library%2FPractice%2FDSM%2FDSM-5%2FChanges-from-DSM-IV-TR--to-DSM-5.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-90"><span class="mw-cite-backlink"><b><a href="#cite_ref-90">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.psychiatry.org/psychiatrists/practice/dsm">"DSM-5"</a>. <i>psychiatry.org</i><span class="reference-accessdate">. Retrieved <span class="nowrap">August 29,</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=psychiatry.org&rft.atitle=DSM-5&rft_id=https%3A%2F%2Fwww.psychiatry.org%2Fpsychiatrists%2Fpractice%2Fdsm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-91"><span class="mw-cite-backlink"><b><a href="#cite_ref-91">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions">"DSM-5 FAQ"</a>. <i>psychiatry.org</i><span class="reference-accessdate">. Retrieved <span class="nowrap">August 29,</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=psychiatry.org&rft.atitle=DSM-5+FAQ&rft_id=https%3A%2F%2Fwww.psychiatry.org%2Fpsychiatrists%2Fpractice%2Fdsm%2Ffeedback-and-questions%2Ffrequently-asked-questions&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-93"><span class="mw-cite-backlink"><b><a href="#cite_ref-93">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFHaroldValora2010" class="citation pressrelease cs1">Harold E, Valora J (March 9, 2010). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20100613144808/http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx">"APA Modifies <i>DSM</i> Naming Convention to Reflect Publication Changes"</a> (Press release). Arlington, VA: American Psychiatric Association. Archived from <a rel="nofollow" class="external text" href="http://psych.org/MainMenu/Newsroom/NewsReleases/2010-News-Releases/DSM-Name-Change.aspx">the original</a> <span class="cs1-format">(PDF)</span> on June 13, 2010. <q>Beginning with the upcoming fifth edition, new versions of the <i>Diagnostic and Statistical Manual of Mental Disorders (DSM)</i> will be identified with Arabic rather than Roman numerals, marking a change in how future updates will be created, ... Incremental updates will be identified with decimals, i.e. <i>DSM-5.1</i>, <i>DSM-5.2</i>, etc., until a new edition is required.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=APA+Modifies+DSM+Naming+Convention+to+Reflect+Publication+Changes&rft.place=Arlington%2C+VA&rft.pub=American+Psychiatric+Association&rft.date=2010-03-09&rft.aulast=Harold&rft.aufirst=E&rft.au=Valora%2C+J&rft_id=http%3A%2F%2Fpsych.org%2FMainMenu%2FNewsroom%2FNewsReleases%2F2010-News-Releases%2FDSM-Name-Change.aspx&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-94"><span class="mw-cite-backlink"><b><a href="#cite_ref-94">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation cs2"><a rel="nofollow" class="external text" href="https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2014.10a19">"Update: Exams to Transition to DSM-5"</a>, <i>Psychiatric News</i>, <b>49</b> (22): 1, 2014, <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.pn.2014.10a19">10.1176/appi.pn.2014.10a19</a></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychiatric+News&rft.atitle=Update%3A+Exams+to+Transition+to+DSM-5&rft.volume=49&rft.issue=22&rft.pages=1&rft.date=2014&rft_id=info%3Adoi%2F10.1176%2Fappi.pn.2014.10a19&rft_id=https%3A%2F%2Fpsychnews.psychiatryonline.org%2Fdoi%2Ffull%2F10.1176%2Fappi.pn.2014.10a19&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:3-95"><span class="mw-cite-backlink"><b><a href="#cite_ref-:3_95-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.appi.org/products/dsm">"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR™)"</a>. <i>American Psychiatric Association</i><span class="reference-accessdate">. Retrieved <span class="nowrap">April 18,</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=American+Psychiatric+Association&rft.atitle=Diagnostic+and+Statistical+Manual+of+Mental+Disorders%2C+Fifth+Edition%2C+Text+Revision+%28DSM-5-TR%E2%84%A2%29&rft_id=https%3A%2F%2Fwww.appi.org%2Fproducts%2Fdsm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:5-96"><span class="mw-cite-backlink">^ <a href="#cite_ref-:5_96-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:5_96-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:5_96-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFAppelbaumLeibenluftKendler2021" class="citation journal cs1">Appelbaum, Paul S.; <a href="/wiki/Ellen_Leibenluft" title="Ellen Leibenluft">Leibenluft, Ellen</a>; Kendler, Kenneth S. (November 1, 2021). "Iterative Revision of the <i>DSM</i>: An Interim Report From the <i>DSM-5</i> Steering Committee". <i>Psychiatric Services</i>. <b>72</b> (11): 1348–1349. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ps.202100013">10.1176/appi.ps.202100013</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/1075-2730">1075-2730</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33882702">33882702</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:233349377">233349377</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychiatric+Services&rft.atitle=Iterative+Revision+of+the+DSM%3A+An+Interim+Report+From+the+DSM-5+Steering+Committee&rft.volume=72&rft.issue=11&rft.pages=1348-1349&rft.date=2021-11-01&rft.issn=1075-2730&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A233349377%23id-name%3DS2CID&rft_id=info%3Apmid%2F33882702&rft_id=info%3Adoi%2F10.1176%2Fappi.ps.202100013&rft.aulast=Appelbaum&rft.aufirst=Paul+S.&rft.au=Leibenluft%2C+Ellen&rft.au=Kendler%2C+Kenneth+S.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:6-97"><span class="mw-cite-backlink">^ <a href="#cite_ref-:6_97-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:6_97-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFirstYousifClarkeWang2022" class="citation journal cs1">First, Michael B.; Yousif, Lamyaa H.; Clarke, Diana E.; Wang, Philip S.; Gogtay, Nitin; Appelbaum, Paul S. (May 7, 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077590">"DSM-5-TR: overview of what's new and what's changed"</a>. <i>World Psychiatry</i>. <b>21</b> (2): 218–219. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fwps.20989">10.1002/wps.20989</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/1723-8617">1723-8617</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077590">9077590</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35524596">35524596</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=World+Psychiatry&rft.atitle=DSM-5-TR%3A+overview+of+what%27s+new+and+what%27s+changed&rft.volume=21&rft.issue=2&rft.pages=218-219&rft.date=2022-05-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9077590%23id-name%3DPMC&rft.issn=1723-8617&rft_id=info%3Apmid%2F35524596&rft_id=info%3Adoi%2F10.1002%2Fwps.20989&rft.aulast=First&rft.aufirst=Michael+B.&rft.au=Yousif%2C+Lamyaa+H.&rft.au=Clarke%2C+Diana+E.&rft.au=Wang%2C+Philip+S.&rft.au=Gogtay%2C+Nitin&rft.au=Appelbaum%2C+Paul+S.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9077590&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-98"><span class="mw-cite-backlink"><b><a href="#cite_ref-98">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/">"Prolonged grief disorder recognized as official diagnosis. Here's what to know about chronic mourning"</a>. <i><a href="/wiki/The_Washington_Post" title="The Washington Post">The Washington Post</a></i>. September 8, 2022. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0190-8286">0190-8286</a><span class="reference-accessdate">. Retrieved <span class="nowrap">May 23,</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Washington+Post&rft.atitle=Prolonged+grief+disorder+recognized+as+official+diagnosis.+Here%27s+what+to+know+about+chronic+mourning.&rft.date=2022-09-08&rft.issn=0190-8286&rft_id=https%3A%2F%2Fwww.washingtonpost.com%2Flifestyle%2F2021%2F10%2F21%2Fprolonged-grief-disorder-diagnosis-dsm-5%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-99"><span class="mw-cite-backlink"><b><a href="#cite_ref-99">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation journal cs1">"Supplemental Material for Same Name, Same Content? Evaluation of DSM-5-TR and ICD-11 Prolonged Grief Criteria". <i>Journal of Consulting and Clinical Psychology</i>. 2022. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1037%2Fccp0000720.supp">10.1037/ccp0000720.supp</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0022-006X">0022-006X</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:248338204">248338204</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Consulting+and+Clinical+Psychology&rft.atitle=Supplemental+Material+for+Same+Name%2C+Same+Content%3F+Evaluation+of+DSM-5-TR+and+ICD-11+Prolonged+Grief+Criteria&rft.date=2022&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A248338204%23id-name%3DS2CID&rft.issn=0022-006X&rft_id=info%3Adoi%2F10.1037%2Fccp0000720.supp&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:4-100"><span class="mw-cite-backlink"><b><a href="#cite_ref-:4_100-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-criteria-text">"Updates to DSM-5 Criteria & Text"</a>. <i>American Psychiatric Association</i><span class="reference-accessdate">. Retrieved <span class="nowrap">April 18,</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=American+Psychiatric+Association&rft.atitle=Updates+to+DSM-5+Criteria+%26+Text&rft_id=https%3A%2F%2Fwww.psychiatry.org%2Fpsychiatrists%2Fpractice%2Fdsm%2Fupdates-to-dsm%2Fupdates-to-dsm-5-criteria-text&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:7-101"><span class="mw-cite-backlink">^ <a href="#cite_ref-:7_101-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:7_101-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://dsm.psychiatryonline.org/">"Psychiatry Online"</a>. <i>DSM Library</i><span class="reference-accessdate">. Retrieved <span class="nowrap">November 7,</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=DSM+Library&rft.atitle=Psychiatry+Online&rft_id=https%3A%2F%2Fdsm.psychiatryonline.org%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-102"><span class="mw-cite-backlink"><b><a href="#cite_ref-102">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGhaemiKnoll_IVPearlman2013" class="citation web cs1">Ghaemi SN, Knoll IV JL, Pearlman T (October 14, 2013). <a rel="nofollow" class="external text" href="http://www.psychiatrictimes.com/blogs/couch-crisis/why-dsm-iii-iv-and-5-are-unscientific">"Why DSM-III, IV, and 5 are Unscientific"</a>. <i>Psychiatric Times: Couch in Crisis Blog</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Psychiatric+Times%3A+Couch+in+Crisis+Blog&rft.atitle=Why+DSM-III%2C+IV%2C+and+5+are+Unscientific&rft.date=2013-10-14&rft.aulast=Ghaemi&rft.aufirst=SN&rft.au=Knoll+IV%2C+JL&rft.au=Pearlman%2C+T&rft_id=http%3A%2F%2Fwww.psychiatrictimes.com%2Fblogs%2Fcouch-crisis%2Fwhy-dsm-iii-iv-and-5-are-unscientific&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-103"><span class="mw-cite-backlink"><b><a href="#cite_ref-103">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKhouryLangerPagnini2014" class="citation journal cs1">Khoury B, Langer EJ, Pagnini F (2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060802">"The DSM: mindful science or mindless power? A critical review"</a>. <i>Frontiers in Psychology</i>. <b>5</b>: 602. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.3389%2Ffpsyg.2014.00602">10.3389/fpsyg.2014.00602</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060802">4060802</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24987385">24987385</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Frontiers+in+Psychology&rft.atitle=The+DSM%3A+mindful+science+or+mindless+power%3F+A+critical+review&rft.volume=5&rft.pages=602&rft.date=2014&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4060802%23id-name%3DPMC&rft_id=info%3Apmid%2F24987385&rft_id=info%3Adoi%2F10.3389%2Ffpsyg.2014.00602&rft.aulast=Khoury&rft.aufirst=B&rft.au=Langer%2C+EJ&rft.au=Pagnini%2C+F&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4060802&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-104"><span class="mw-cite-backlink"><b><a href="#cite_ref-104">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFInsel2013" class="citation web cs1">Insel T (April 29, 2013). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130529152509/http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml">"Transforming Diagnosis"</a>. <i>Director's Blog</i>. National Institute of Mental Health. Archived from <a rel="nofollow" class="external text" href="http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml">the original</a> on May 29, 2013<span class="reference-accessdate">. Retrieved <span class="nowrap">September 2,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Director%27s+Blog&rft.atitle=Transforming+Diagnosis&rft.date=2013-04-29&rft.aulast=Insel&rft.aufirst=T&rft_id=http%3A%2F%2Fwww.nimh.nih.gov%2Fabout%2Fdirector%2F2013%2Ftransforming-diagnosis.shtml&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-105"><span class="mw-cite-backlink"><b><a href="#cite_ref-105">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20190223235629/https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml">"NIMH » Transforming Diagnosis"</a>. <i>nimh.nih.gov</i>. Archived from <a rel="nofollow" class="external text" href="https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml">the original</a> on February 23, 2019<span class="reference-accessdate">. Retrieved <span class="nowrap">February 25,</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=nimh.nih.gov&rft.atitle=NIMH+%C2%BB+Transforming+Diagnosis&rft_id=https%3A%2F%2Fwww.nimh.nih.gov%2Fabout%2Fdirectors%2Fthomas-insel%2Fblog%2F2013%2Ftransforming-diagnosis.shtml&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-106"><span class="mw-cite-backlink"><b><a href="#cite_ref-106">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFLane" class="citation magazine cs1">Lane C. <a rel="nofollow" class="external text" href="http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5">"The NIMH Withdraws Support for DSM-5"</a>. <i>Psychology Today</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychology+Today&rft.atitle=The+NIMH+Withdraws+Support+for+DSM-5&rft.aulast=Lane&rft.aufirst=C&rft_id=http%3A%2F%2Fwww.psychologytoday.com%2Fblog%2Fside-effects%2F201305%2Fthe-nimh-withdraws-support-dsm-5&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-107"><span class="mw-cite-backlink"><b><a href="#cite_ref-107">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFreedmanLewisMichelsPine2013" class="citation journal cs1">Freedman R, Lewis DA, Michels R, Pine DS, Schultz SK, Tamminga CA, et al. (January 2013). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130115024502/http://ajp.psychiatryonline.org/article.aspx?articleID=1555604">"The initial field trials of DSM-5: new blooms and old thorns"</a>. <i>The American Journal of Psychiatry</i>. <b>170</b> (1): 1–5. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ajp.2012.12091189">10.1176/appi.ajp.2012.12091189</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23288382">23288382</a>. Archived from <a rel="nofollow" class="external text" href="http://ajp.psychiatryonline.org/article.aspx?articleid=1555604">the original</a> on January 15, 2013.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=The+initial+field+trials+of+DSM-5%3A+new+blooms+and+old+thorns&rft.volume=170&rft.issue=1&rft.pages=1-5&rft.date=2013-01&rft_id=info%3Adoi%2F10.1176%2Fappi.ajp.2012.12091189&rft_id=info%3Apmid%2F23288382&rft.aulast=Freedman&rft.aufirst=R&rft.au=Lewis%2C+DA&rft.au=Michels%2C+R&rft.au=Pine%2C+DS&rft.au=Schultz%2C+SK&rft.au=Tamminga%2C+CA&rft.au=Gabbard%2C+GO&rft.au=Gau%2C+SS&rft.au=Javitt%2C+DC&rft.au=Oquendo%2C+MA&rft.au=Shrout%2C+PE&rft.au=Vieta%2C+E&rft.au=Yager%2C+J&rft_id=http%3A%2F%2Fajp.psychiatryonline.org%2Farticle.aspx%3Farticleid%3D1555604&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-108"><span class="mw-cite-backlink"><b><a href="#cite_ref-108">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMcHugh2005" class="citation journal cs1">McHugh PR (May 2005). "Striving for coherence: psychiatry's efforts over classification". <i>JAMA</i>. <b>293</b> (20): 2526–2528. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.293.20.2526">10.1001/jama.293.20.2526</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15914753">15914753</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=JAMA&rft.atitle=Striving+for+coherence%3A+psychiatry%27s+efforts+over+classification&rft.volume=293&rft.issue=20&rft.pages=2526-2528&rft.date=2005-05&rft_id=info%3Adoi%2F10.1001%2Fjama.293.20.2526&rft_id=info%3Apmid%2F15914753&rft.aulast=McHugh&rft.aufirst=PR&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-109"><span class="mw-cite-backlink"><b><a href="#cite_ref-109">^</a></b></span> <span class="reference-text">Fadul. J. A. (2014) Diagnostic and Statistical Manual of Mental Disorders. In <i>Encyclopedia of Theory & Practice in Psychopathology & Counseling.</i> (p. 143). Raleigh, NC: Lulu Press.</span>
</li>
<li id="cite_note-110"><span class="mw-cite-backlink"><b><a href="#cite_ref-110">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFDavis1980" class="citation journal cs1">Davis JB (April 1980). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1801862">"Classification of psychiatric disorders"</a>. <i>Canadian Medical Association Journal</i>. <b>122</b> (7): 750. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1801862">1801862</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20313414">20313414</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Canadian+Medical+Association+Journal&rft.atitle=Classification+of+psychiatric+disorders&rft.volume=122&rft.issue=7&rft.pages=750&rft.date=1980-04&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1801862%23id-name%3DPMC&rft_id=info%3Apmid%2F20313414&rft.aulast=Davis&rft.aufirst=JB&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1801862&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-111"><span class="mw-cite-backlink"><b><a href="#cite_ref-111">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMurphyStich1998" class="citation web cs1">Murphy D, Stich S (December 16, 1998). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20131205122638/http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html">"Darwin in the Madhouse: Evolutionary Psychology and the Classification of Mental Disorders"</a>. Archived from <a rel="nofollow" class="external text" href="http://ruccs.rutgers.edu/ArchiveFolder/Research%20Group/Publications/Mad/Madhouse.html">the original</a> on December 5, 2013<span class="reference-accessdate">. Retrieved <span class="nowrap">December 3,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Darwin+in+the+Madhouse%3A+Evolutionary+Psychology+and+the+Classification+of+Mental+Disorders&rft.date=1998-12-16&rft.aulast=Murphy&rft.aufirst=D&rft.au=Stich%2C+S&rft_id=http%3A%2F%2Fruccs.rutgers.edu%2FArchiveFolder%2FResearch%2520Group%2FPublications%2FMad%2FMadhouse.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-112"><span class="mw-cite-backlink"><b><a href="#cite_ref-112">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCosmidesTooby1999" class="citation journal cs1">Cosmides L, Tooby J (August 1999). "Toward an evolutionary taxonomy of treatable conditions". <i>Journal of Abnormal Psychology</i>. <b>108</b> (3): 453–464. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1037%2F0021-843x.108.3.453">10.1037/0021-843x.108.3.453</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10466269">10466269</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Abnormal+Psychology&rft.atitle=Toward+an+evolutionary+taxonomy+of+treatable+conditions&rft.volume=108&rft.issue=3&rft.pages=453-464&rft.date=1999-08&rft_id=info%3Adoi%2F10.1037%2F0021-843x.108.3.453&rft_id=info%3Apmid%2F10466269&rft.aulast=Cosmides&rft.aufirst=L&rft.au=Tooby%2C+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-113"><span class="mw-cite-backlink"><b><a href="#cite_ref-113">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMcNally2001" class="citation journal cs1">McNally RJ (March 2001). "On Wakefield's harmful dysfunction analysis of mental disorder". <i>Behaviour Research and Therapy</i>. <b>39</b> (3): 309–314. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0005-7967%2800%2900068-1">10.1016/S0005-7967(00)00068-1</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11227812">11227812</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Behaviour+Research+and+Therapy&rft.atitle=On+Wakefield%27s+harmful+dysfunction+analysis+of+mental+disorder&rft.volume=39&rft.issue=3&rft.pages=309-314&rft.date=2001-03&rft_id=info%3Adoi%2F10.1016%2FS0005-7967%2800%2900068-1&rft_id=info%3Apmid%2F11227812&rft.aulast=McNally&rft.aufirst=RJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-114"><span class="mw-cite-backlink"><b><a href="#cite_ref-114">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFHands2004" class="citation journal cs1">Hands DW (December 2004). "On Operationalisms and Economics". <i>Journal of Economic Issues</i>. <b>38</b> (4): 953–968. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1080%2F00213624.2004.11506751">10.1080/00213624.2004.11506751</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:141997867">141997867</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Economic+Issues&rft.atitle=On+Operationalisms+and+Economics&rft.volume=38&rft.issue=4&rft.pages=953-968&rft.date=2004-12&rft_id=info%3Adoi%2F10.1080%2F00213624.2004.11506751&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A141997867%23id-name%3DS2CID&rft.aulast=Hands&rft.aufirst=DW&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-nordgaard1-115"><span class="mw-cite-backlink"><b><a href="#cite_ref-nordgaard1_115-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFNordgaardSassParnas2013" class="citation journal cs1"><a href="/w/index.php?title=Julie_Nordgaard&action=edit&redlink=1" class="new" title="Julie Nordgaard (page does not exist)">Nordgaard J</a>, <a href="/wiki/Louis_Sass" title="Louis Sass">Sass LA</a>, Parnas J (June 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668119">"The psychiatric interview: validity, structure, and subjectivity"</a>. <i>European Archives of Psychiatry and Clinical Neuroscience</i>. <b>263</b> (4): 353–364. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00406-012-0366-z">10.1007/s00406-012-0366-z</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668119">3668119</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23001456">23001456</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=European+Archives+of+Psychiatry+and+Clinical+Neuroscience&rft.atitle=The+psychiatric+interview%3A+validity%2C+structure%2C+and+subjectivity&rft.volume=263&rft.issue=4&rft.pages=353-364&rft.date=2013-06&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3668119%23id-name%3DPMC&rft_id=info%3Apmid%2F23001456&rft_id=info%3Adoi%2F10.1007%2Fs00406-012-0366-z&rft.aulast=Nordgaard&rft.aufirst=J&rft.au=Sass%2C+LA&rft.au=Parnas%2C+J&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3668119&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-116"><span class="mw-cite-backlink"><b><a href="#cite_ref-116">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFOlivier2015" class="citation journal cs1">Olivier, B (2015). <a rel="nofollow" class="external text" href="http://ref.scielo.org/w7qdd5">"Capitalism and suffering"</a>. <i>Psychology in Society</i>. <b>48</b>: 1–21. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.17159%2F2309-8708%2F2015%2Fn48a1">10.17159/2309-8708/2015/n48a1</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychology+in+Society&rft.atitle=Capitalism+and+suffering&rft.volume=48&rft.pages=1-21&rft.date=2015&rft_id=info%3Adoi%2F10.17159%2F2309-8708%2F2015%2Fn48a1&rft.aulast=Olivier&rft.aufirst=B&rft_id=http%3A%2F%2Fref.scielo.org%2Fw7qdd5&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-117"><span class="mw-cite-backlink"><b><a href="#cite_ref-117">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCosgroveWheeler2013" class="citation journal cs1">Cosgrove, Lisa; Wheeler, Emily E (February 8, 2013). <a rel="nofollow" class="external text" href="http://journals.sagepub.com/doi/10.1177/0959353512467972">"Industry's colonization of psychiatry: Ethical and practical implications of financial conflicts of interest in the DSM-5"</a>. <i><a href="/wiki/Feminism_%26_Psychology" title="Feminism & Psychology">Feminism & Psychology</a></i>. <b>23</b> (1): 93–106. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F0959353512467972">10.1177/0959353512467972</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0959-3535">0959-3535</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Feminism+%26+Psychology&rft.atitle=Industry%27s+colonization+of+psychiatry%3A+Ethical+and+practical+implications+of+financial+conflicts+of+interest+in+the+DSM-5&rft.volume=23&rft.issue=1&rft.pages=93-106&rft.date=2013-02-08&rft_id=info%3Adoi%2F10.1177%2F0959353512467972&rft.issn=0959-3535&rft.aulast=Cosgrove&rft.aufirst=Lisa&rft.au=Wheeler%2C+Emily+E&rft_id=http%3A%2F%2Fjournals.sagepub.com%2Fdoi%2F10.1177%2F0959353512467972&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-118"><span class="mw-cite-backlink"><b><a href="#cite_ref-118">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMagee2019" class="citation book cs1">Magee, Mike (2019). <i>Code blue: inside America's medical industrial complex</i> (1st ed.). New York: <a href="/wiki/Atlantic_Monthly_Press" class="mw-redirect" title="Atlantic Monthly Press">Atlantic Monthly Press</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-8021-4687-8" title="Special:BookSources/978-0-8021-4687-8"><bdi>978-0-8021-4687-8</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Code+blue%3A+inside+America%27s+medical+industrial+complex&rft.place=New+York&rft.edition=1st&rft.pub=Atlantic+Monthly+Press&rft.date=2019&rft.isbn=978-0-8021-4687-8&rft.aulast=Magee&rft.aufirst=Mike&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-119"><span class="mw-cite-backlink"><b><a href="#cite_ref-119">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFLane2007" class="citation book cs1">Lane, Christopher (2007). <i>Shyness: how normal behavior became a sickness</i>. New Haven: Yale University Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-300-14317-1" title="Special:BookSources/978-0-300-14317-1"><bdi>978-0-300-14317-1</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Shyness%3A+how+normal+behavior+became+a+sickness&rft.place=New+Haven&rft.pub=Yale+University+Press&rft.date=2007&rft.isbn=978-0-300-14317-1&rft.aulast=Lane&rft.aufirst=Christopher&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-120"><span class="mw-cite-backlink"><b><a href="#cite_ref-120">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFTone2012" class="citation book cs1">Tone, Andrea (January 3, 2012). <i>The Age of Anxiety: A History of America's Turbulent Affairs with Tranquilizers</i> (1st ed.). New York: <a href="/wiki/Basic_Books" title="Basic Books">Basic Books</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0465025206" title="Special:BookSources/978-0465025206"><bdi>978-0465025206</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+Age+of+Anxiety%3A+A+History+of+America%27s+Turbulent+Affairs+with+Tranquilizers&rft.place=New+York&rft.edition=1st&rft.pub=Basic+Books&rft.date=2012-01-03&rft.isbn=978-0465025206&rft.aulast=Tone&rft.aufirst=Andrea&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-121"><span class="mw-cite-backlink"><b><a href="#cite_ref-121">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFTimler2022" class="citation journal cs1">Timler, Kelsey (2022). <a rel="nofollow" class="external text" href="https://www.cambridge.org/core/product/identifier/S0887536722000605/type/journal_article">"Distorted Thinking or Distorted Realities? The Social Construction of Anxiety for Women in Neoliberal Late-Stage Capitalism"</a>. <i>Hypatia</i>. <b>37</b> (4): 726–742. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1017%2Fhyp.2022.60">10.1017/hyp.2022.60</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0887-5367">0887-5367</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Hypatia&rft.atitle=Distorted+Thinking+or+Distorted+Realities%3F+The+Social+Construction+of+Anxiety+for+Women+in+Neoliberal+Late-Stage+Capitalism&rft.volume=37&rft.issue=4&rft.pages=726-742&rft.date=2022&rft_id=info%3Adoi%2F10.1017%2Fhyp.2022.60&rft.issn=0887-5367&rft.aulast=Timler&rft.aufirst=Kelsey&rft_id=https%3A%2F%2Fwww.cambridge.org%2Fcore%2Fproduct%2Fidentifier%2FS0887536722000605%2Ftype%2Fjournal_article&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-122"><span class="mw-cite-backlink"><b><a href="#cite_ref-122">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKincaidSullivan2014" class="citation book cs1">Kincaid, Harold; Sullivan, Jacqueline A., eds. (April 4, 2014). <a rel="nofollow" class="external text" href="https://direct.mit.edu/books/book/3043/Classifying-PsychopathologyMental-Kinds-and"><i>Classifying Psychopathology: Mental Kinds and Natural Kinds</i></a>. The MIT Press. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7551%2Fmitpress%2F8942.001.0001">10.7551/mitpress/8942.001.0001</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-262-32243-0" title="Special:BookSources/978-0-262-32243-0"><bdi>978-0-262-32243-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Classifying+Psychopathology%3A+Mental+Kinds+and+Natural+Kinds&rft.pub=The+MIT+Press&rft.date=2014-04-04&rft_id=info%3Adoi%2F10.7551%2Fmitpress%2F8942.001.0001&rft.isbn=978-0-262-32243-0&rft_id=https%3A%2F%2Fdirect.mit.edu%2Fbooks%2Fbook%2F3043%2FClassifying-PsychopathologyMental-Kinds-and&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:10-123"><span class="mw-cite-backlink">^ <a href="#cite_ref-:10_123-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:10_123-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFDavies2022" class="citation book cs1">Davies, James (March 3, 2022). <i>Sedated: How Modern Capitalism Created our Mental Health Crisis</i> (1st ed.). London: <a href="/wiki/Atlantic_Books" title="Atlantic Books">Atlantic Books</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1786499875" title="Special:BookSources/978-1786499875"><bdi>978-1786499875</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Sedated%3A+How+Modern+Capitalism+Created+our+Mental+Health+Crisis&rft.place=London&rft.edition=1st&rft.pub=Atlantic+Books&rft.date=2022-03-03&rft.isbn=978-1786499875&rft.aulast=Davies&rft.aufirst=James&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-124"><span class="mw-cite-backlink"><b><a href="#cite_ref-124">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFDavies2014" class="citation book cs1">Davies, James (2014). <i>Cracked: why psychiatry is doing more harm than good</i>. London: <a href="/wiki/Icon_Books" class="mw-redirect" title="Icon Books">Icon</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-84831-654-6" title="Special:BookSources/978-1-84831-654-6"><bdi>978-1-84831-654-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Cracked%3A+why+psychiatry+is+doing+more+harm+than+good&rft.place=London&rft.pub=Icon&rft.date=2014&rft.isbn=978-1-84831-654-6&rft.aulast=Davies&rft.aufirst=James&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:11-125"><span class="mw-cite-backlink">^ <a href="#cite_ref-:11_125-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:11_125-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFU'Ren1997" class="citation journal cs1">U'Ren, Richard (1997). <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/43853806">"Psychiatry and Capitalism"</a>. <i>The Journal of Mind and Behavior</i>. <b>18</b> (1): 1–11. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0271-0137">0271-0137</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a> <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/43853806">43853806</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Mind+and+Behavior&rft.atitle=Psychiatry+and+Capitalism&rft.volume=18&rft.issue=1&rft.pages=1-11&rft.date=1997&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F43853806%23id-name%3DJSTOR&rft.issn=0271-0137&rft.aulast=U%27Ren&rft.aufirst=Richard&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F43853806&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-126"><span class="mw-cite-backlink"><b><a href="#cite_ref-126">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBarney1994" class="citation journal cs1">Barney, Ken (1994). <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/43853630">"Limitations of the Critique of the Medical Model"</a>. <i>The Journal of Mind and Behavior</i>. <b>15</b> (1/2): 19–34. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0271-0137">0271-0137</a>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a> <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/43853630">43853630</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Mind+and+Behavior&rft.atitle=Limitations+of+the+Critique+of+the+Medical+Model&rft.volume=15&rft.issue=1%2F2&rft.pages=19-34&rft.date=1994&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F43853630%23id-name%3DJSTOR&rft.issn=0271-0137&rft.aulast=Barney&rft.aufirst=Ken&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F43853630&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-127"><span class="mw-cite-backlink"><b><a href="#cite_ref-127">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFLebowitzAhn2014" class="citation journal cs1">Lebowitz, Matthew S.; Ahn, Woo-kyoung (December 16, 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273344">"Effects of biological explanations for mental disorders on clinicians' empathy"</a>. <i>Proceedings of the National Academy of Sciences</i>. <b>111</b> (50): 17786–17790. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2014PNAS..11117786L">2014PNAS..11117786L</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1073%2Fpnas.1414058111">10.1073/pnas.1414058111</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0027-8424">0027-8424</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273344">4273344</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25453068">25453068</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Proceedings+of+the+National+Academy+of+Sciences&rft.atitle=Effects+of+biological+explanations+for+mental+disorders+on+clinicians%27+empathy&rft.volume=111&rft.issue=50&rft.pages=17786-17790&rft.date=2014-12-16&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4273344%23id-name%3DPMC&rft_id=info%3Abibcode%2F2014PNAS..11117786L&rft_id=info%3Apmid%2F25453068&rft_id=info%3Adoi%2F10.1073%2Fpnas.1414058111&rft.issn=0027-8424&rft.aulast=Lebowitz&rft.aufirst=Matthew+S.&rft.au=Ahn%2C+Woo-kyoung&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4273344&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-128"><span class="mw-cite-backlink"><b><a href="#cite_ref-128">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBriggs2000" class="citation journal cs1">Briggs, Laura (June 2000). <a rel="nofollow" class="external text" href="https://muse.jhu.edu/article/2437">"The Race of Hysteria: "Overcivilization" and the "Savage" Woman in Late Nineteenth-Century Obstetrics and Gynecology"</a>. <i>American Quarterly</i>. <b>52</b> (2): 246–273. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1353%2Faq.2000.0013">10.1353/aq.2000.0013</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/1080-6490">1080-6490</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16858900">16858900</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Quarterly&rft.atitle=The+Race+of+Hysteria%3A+%22Overcivilization%22+and+the+%22Savage%22+Woman+in+Late+Nineteenth-Century+Obstetrics+and+Gynecology&rft.volume=52&rft.issue=2&rft.pages=246-273&rft.date=2000-06&rft.issn=1080-6490&rft_id=info%3Apmid%2F16858900&rft_id=info%3Adoi%2F10.1353%2Faq.2000.0013&rft.aulast=Briggs&rft.aufirst=Laura&rft_id=https%3A%2F%2Fmuse.jhu.edu%2Farticle%2F2437&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-129"><span class="mw-cite-backlink"><b><a href="#cite_ref-129">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFHogarth2017" class="citation book cs1">Hogarth, Rana A. (2017). <i>Medicalizing blackness: making racial difference in the Atlantic world, 1780-1840</i>. Chapel Hill: The University of North Carolina Press. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4696-3286-5" title="Special:BookSources/978-1-4696-3286-5"><bdi>978-1-4696-3286-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Medicalizing+blackness%3A+making+racial+difference+in+the+Atlantic+world%2C+1780-1840&rft.place=Chapel+Hill&rft.pub=The+University+of+North+Carolina+Press&rft.date=2017&rft.isbn=978-1-4696-3286-5&rft.aulast=Hogarth&rft.aufirst=Rana+A.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:12-130"><span class="mw-cite-backlink">^ <a href="#cite_ref-:12_130-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:12_130-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBrinkmann2016" class="citation book cs1">Brinkmann, Svend (2016). <i>Diagnostic cultures: a cultural approach to the pathologization of modern life</i>. Classical and contemporary social theory. London ; New York: Routledge, Taylor Francis Group. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4724-1319-2" title="Special:BookSources/978-1-4724-1319-2"><bdi>978-1-4724-1319-2</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Diagnostic+cultures%3A+a+cultural+approach+to+the+pathologization+of+modern+life&rft.place=London+%3B+New+York&rft.series=Classical+and+contemporary+social+theory&rft.pub=Routledge%2C+Taylor+Francis+Group&rft.date=2016&rft.isbn=978-1-4724-1319-2&rft.aulast=Brinkmann&rft.aufirst=Svend&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-:13-131"><span class="mw-cite-backlink">^ <a href="#cite_ref-:13_131-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:13_131-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMetzl2011" class="citation book cs1">Metzl, Jonathan Michel (2011). <i>The protest psychosis: how schizophrenia became a black disease</i>. Boston, Mass: Beacon. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-8070-0127-1" title="Special:BookSources/978-0-8070-0127-1"><bdi>978-0-8070-0127-1</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+protest+psychosis%3A+how+schizophrenia+became+a+black+disease&rft.place=Boston%2C+Mass&rft.pub=Beacon&rft.date=2011&rft.isbn=978-0-8070-0127-1&rft.aulast=Metzl&rft.aufirst=Jonathan+Michel&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-132"><span class="mw-cite-backlink"><b><a href="#cite_ref-132">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBen-MosheCarey2014" class="citation book cs1">Ben-Moshe, Liat; Carey, Allison C., eds. (2014). <i>Disability incarcerated: imprisonment and disability in the United States and Canada</i>. New York, NY: Palgrave Macmillan. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-137-39323-4" title="Special:BookSources/978-1-137-39323-4"><bdi>978-1-137-39323-4</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Disability+incarcerated%3A+imprisonment+and+disability+in+the+United+States+and+Canada&rft.place=New+York%2C+NY&rft.pub=Palgrave+Macmillan&rft.date=2014&rft.isbn=978-1-137-39323-4&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-133"><span class="mw-cite-backlink"><b><a href="#cite_ref-133">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFPrinsBatesKeyesMuntaner2015" class="citation journal cs1">Prins, Seth J.; Bates, Lisa M.; Keyes, Katherine M.; Muntaner, Carles (November 1, 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609238">"Anxious? Depressed? You might be suffering from capitalism: contradictory class locations and the prevalence of depression and anxiety in the USA"</a>. <i>Sociology of Health & Illness</i>. <b>37</b> (8): 1352–1372. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2F1467-9566.12315">10.1111/1467-9566.12315</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/0141-9889">0141-9889</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609238">4609238</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26385581">26385581</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Sociology+of+Health+%26+Illness&rft.atitle=Anxious%3F+Depressed%3F+You+might+be+suffering+from+capitalism%3A+contradictory+class+locations+and+the+prevalence+of+depression+and+anxiety+in+the+USA&rft.volume=37&rft.issue=8&rft.pages=1352-1372&rft.date=2015-11-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4609238%23id-name%3DPMC&rft.issn=0141-9889&rft_id=info%3Apmid%2F26385581&rft_id=info%3Adoi%2F10.1111%2F1467-9566.12315&rft.aulast=Prins&rft.aufirst=Seth+J.&rft.au=Bates%2C+Lisa+M.&rft.au=Keyes%2C+Katherine+M.&rft.au=Muntaner%2C+Carles&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4609238&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-134"><span class="mw-cite-backlink"><b><a href="#cite_ref-134">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://psychcentral.com/blog/overdiagnosis-mental-disorders-and-the-dsm-5/">"Overdiagnosis, Mental Disorders and the DSM-5"</a>. <i>World of Psychology</i>. July 26, 2010<span class="reference-accessdate">. Retrieved <span class="nowrap">September 18,</span> 2018</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=World+of+Psychology&rft.atitle=Overdiagnosis%2C+Mental+Disorders+and+the+DSM-5&rft.date=2010-07-26&rft_id=https%3A%2F%2Fpsychcentral.com%2Fblog%2Foverdiagnosis-mental-disorders-and-the-dsm-5%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-135"><span class="mw-cite-backlink"><b><a href="#cite_ref-135">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.psychologytoday.com/us/blog/dsm5-in-distress/201006/psychiatric-fads-and-overdiagnosis">"Psychiatric Fads and Overdiagnosis"</a>. <i>Psychology Today</i><span class="reference-accessdate">. Retrieved <span class="nowrap">September 18,</span> 2018</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Psychology+Today&rft.atitle=Psychiatric+Fads+and+Overdiagnosis&rft_id=https%3A%2F%2Fwww.psychologytoday.com%2Fus%2Fblog%2Fdsm5-in-distress%2F201006%2Fpsychiatric-fads-and-overdiagnosis&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-136"><span class="mw-cite-backlink"><b><a href="#cite_ref-136">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFThomasMitchellBatstra2013" class="citation journal cs1">Thomas R, Mitchell GK, Batstra L (November 2013). <a rel="nofollow" class="external text" href="http://www.bmj.com/cgi/content/short/348/jul01_1/g4377">"Attention-deficit/hyperactivity disorder: are we helping or harming?"</a>. <i>BMJ</i>. <b>347</b> (nov05 1): f6172. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.f6172">10.1136/bmj.f6172</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24192646">24192646</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:32080132">32080132</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=BMJ&rft.atitle=Attention-deficit%2Fhyperactivity+disorder%3A+are+we+helping+or+harming%3F&rft.volume=347&rft.issue=nov05+1&rft.pages=f6172&rft.date=2013-11&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A32080132%23id-name%3DS2CID&rft_id=info%3Apmid%2F24192646&rft_id=info%3Adoi%2F10.1136%2Fbmj.f6172&rft.aulast=Thomas&rft.aufirst=R&rft.au=Mitchell%2C+GK&rft.au=Batstra%2C+L&rft_id=http%3A%2F%2Fwww.bmj.com%2Fcgi%2Fcontent%2Fshort%2F348%2Fjul01_1%2Fg4377&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-bruchmuller_2012-137"><span class="mw-cite-backlink">^ <a href="#cite_ref-bruchmuller_2012_137-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-bruchmuller_2012_137-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFBruchmüllerMargrafSchneider2012" class="citation journal cs1">Bruchmüller K, Margraf J, Schneider S (February 2012). "Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis". <i>Journal of Consulting and Clinical Psychology</i>. <b>80</b> (1): 128–138. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1037%2Fa0026582">10.1037/a0026582</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22201328">22201328</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:6436414">6436414</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Consulting+and+Clinical+Psychology&rft.atitle=Is+ADHD+diagnosed+in+accord+with+diagnostic+criteria%3F+Overdiagnosis+and+influence+of+client+gender+on+diagnosis&rft.volume=80&rft.issue=1&rft.pages=128-138&rft.date=2012-02&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A6436414%23id-name%3DS2CID&rft_id=info%3Apmid%2F22201328&rft_id=info%3Adoi%2F10.1037%2Fa0026582&rft.aulast=Bruchm%C3%BCller&rft.aufirst=K&rft.au=Margraf%2C+J&rft.au=Schneider%2C+S&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-138"><span class="mw-cite-backlink"><b><a href="#cite_ref-138">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFVande_VoortHeJamesonMerikangas2014" class="citation journal cs1">Vande Voort JL, He JP, Jameson ND, Merikangas KR (July 2014). "Impact of the DSM-5 attention-deficit/hyperactivity disorder age-of-onset criterion in the US adolescent population". <i>Journal of the American Academy of Child and Adolescent Psychiatry</i>. <b>53</b> (7): 736–744. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jaac.2014.03.005">10.1016/j.jaac.2014.03.005</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24954823">24954823</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+American+Academy+of+Child+and+Adolescent+Psychiatry&rft.atitle=Impact+of+the+DSM-5+attention-deficit%2Fhyperactivity+disorder+age-of-onset+criterion+in+the+US+adolescent+population&rft.volume=53&rft.issue=7&rft.pages=736-744&rft.date=2014-07&rft_id=info%3Adoi%2F10.1016%2Fj.jaac.2014.03.005&rft_id=info%3Apmid%2F24954823&rft.aulast=Vande+Voort&rft.aufirst=JL&rft.au=He%2C+JP&rft.au=Jameson%2C+ND&rft.au=Merikangas%2C+KR&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-139"><span class="mw-cite-backlink"><b><a href="#cite_ref-139">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFWingPotter2002" class="citation journal cs1">Wing L, Potter D (2002). "The epidemiology of autistic spectrum disorders: is the prevalence rising?". <i>Mental Retardation and Developmental Disabilities Research Reviews</i>. <b>8</b> (3): 151–161. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fmrdd.10029">10.1002/mrdd.10029</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12216059">12216059</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Mental+Retardation+and+Developmental+Disabilities+Research+Reviews&rft.atitle=The+epidemiology+of+autistic+spectrum+disorders%3A+is+the+prevalence+rising%3F&rft.volume=8&rft.issue=3&rft.pages=151-161&rft.date=2002&rft_id=info%3Adoi%2F10.1002%2Fmrdd.10029&rft_id=info%3Apmid%2F12216059&rft.aulast=Wing&rft.aufirst=L&rft.au=Potter%2C+D&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-140"><span class="mw-cite-backlink"><b><a href="#cite_ref-140">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpitzerWilliamsFirstGibbon" class="citation web cs1">Spitzer RL, Williams JB, First MB, Gibbon M. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20030307205740/http://nyspi.org/AR2001/Biometrics.htm">"Biometric Research"</a>. <i>Psychiatric Institute 2001-2002</i>. New York State Psychiatric Institute. Archived from <a rel="nofollow" class="external text" href="http://nyspi.org/AR2001/Biometrics.htm">the original</a> on March 7, 2003.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Psychiatric+Institute+2001-2002&rft.atitle=Biometric+Research&rft.aulast=Spitzer&rft.aufirst=RL&rft.au=Williams%2C+JB&rft.au=First%2C+MB&rft.au=Gibbon%2C+M&rft_id=http%3A%2F%2Fnyspi.org%2FAR2001%2FBiometrics.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-141"><span class="mw-cite-backlink"><b><a href="#cite_ref-141">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMaserAkiskal2002" class="citation journal cs1">Maser JD, Akiskal HS (December 2002). "Spectrum concepts in major mental disorders". <i>The Psychiatric Clinics of North America</i>. <b>25</b> (4): xi–xiii. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0193-953X%2802%2900034-5">10.1016/S0193-953X(02)00034-5</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12462854">12462854</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Psychiatric+Clinics+of+North+America&rft.atitle=Spectrum+concepts+in+major+mental+disorders&rft.volume=25&rft.issue=4&rft.pages=xi-xiii&rft.date=2002-12&rft_id=info%3Adoi%2F10.1016%2FS0193-953X%2802%2900034-5&rft_id=info%3Apmid%2F12462854&rft.aulast=Maser&rft.aufirst=JD&rft.au=Akiskal%2C+HS&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-142"><span class="mw-cite-backlink"><b><a href="#cite_ref-142">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKruegerWatsonBarlow2005" class="citation journal cs1">Krueger RF, Watson D, Barlow DH (November 2005). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242426">"Introduction to the special section: toward a dimensionally based taxonomy of psychopathology"</a>. <i>Journal of Abnormal Psychology</i>. <b>114</b> (4): 491–493. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1037%2F0021-843X.114.4.491">10.1037/0021-843X.114.4.491</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242426">2242426</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16351372">16351372</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Abnormal+Psychology&rft.atitle=Introduction+to+the+special+section%3A+toward+a+dimensionally+based+taxonomy+of+psychopathology&rft.volume=114&rft.issue=4&rft.pages=491-493&rft.date=2005-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2242426%23id-name%3DPMC&rft_id=info%3Apmid%2F16351372&rft_id=info%3Adoi%2F10.1037%2F0021-843X.114.4.491&rft.aulast=Krueger&rft.aufirst=RF&rft.au=Watson%2C+D&rft.au=Barlow%2C+DH&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2242426&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-143"><span class="mw-cite-backlink"><b><a href="#cite_ref-143">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFWakefieldSchmitzFirstHorwitz2007" class="citation journal cs1">Wakefield JC, Schmitz MF, First MB, Horwitz AV (April 2007). "Extending the bereavement exclusion for major depression to other losses: evidence from the National Comorbidity Survey". <i>Archives of General Psychiatry</i>. <b>64</b> (4): 433–440. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchpsyc.64.4.433">10.1001/archpsyc.64.4.433</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17404120">17404120</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+General+Psychiatry&rft.atitle=Extending+the+bereavement+exclusion+for+major+depression+to+other+losses%3A+evidence+from+the+National+Comorbidity+Survey&rft.volume=64&rft.issue=4&rft.pages=433-440&rft.date=2007-04&rft_id=info%3Adoi%2F10.1001%2Farchpsyc.64.4.433&rft_id=info%3Apmid%2F17404120&rft.aulast=Wakefield&rft.aufirst=JC&rft.au=Schmitz%2C+MF&rft.au=First%2C+MB&rft.au=Horwitz%2C+AV&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-144"><span class="mw-cite-backlink"><b><a href="#cite_ref-144">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpitzerWakefield1999" class="citation journal cs1">Spitzer RL, Wakefield JC (December 1999). "DSM-IV diagnostic criterion for clinical significance: does it help solve the false positives problem?". <i>The American Journal of Psychiatry</i>. <b>156</b> (12): 1856–1864. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.156.12.1856">10.1176/ajp.156.12.1856</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10588397">10588397</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:25642814">25642814</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=DSM-IV+diagnostic+criterion+for+clinical+significance%3A+does+it+help+solve+the+false+positives+problem%3F&rft.volume=156&rft.issue=12&rft.pages=1856-1864&rft.date=1999-12&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A25642814%23id-name%3DS2CID&rft_id=info%3Apmid%2F10588397&rft_id=info%3Adoi%2F10.1176%2Fajp.156.12.1856&rft.aulast=Spitzer&rft.aufirst=RL&rft.au=Wakefield%2C+JC&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Widiger2000-145"><span class="mw-cite-backlink">^ <a href="#cite_ref-Widiger2000_145-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Widiger2000_145-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Widiger2000_145-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFWidigerSankis2000" class="citation journal cs1">Widiger TA, Sankis LM (2000). "Adult psychopathology: issues and controversies". <i>Annual Review of Psychology</i>. <b>51</b> (1): 377–404. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1146%2Fannurev.psych.51.1.377">10.1146/annurev.psych.51.1.377</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10751976">10751976</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Annual+Review+of+Psychology&rft.atitle=Adult+psychopathology%3A+issues+and+controversies&rft.volume=51&rft.issue=1&rft.pages=377-404&rft.date=2000&rft_id=info%3Adoi%2F10.1146%2Fannurev.psych.51.1.377&rft_id=info%3Apmid%2F10751976&rft.aulast=Widiger&rft.aufirst=TA&rft.au=Sankis%2C+LM&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-wash-post-146"><span class="mw-cite-backlink"><b><a href="#cite_ref-wash-post_146-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFVedantam2005" class="citation news cs1">Vedantam S (June 26, 2005). <a rel="nofollow" class="external text" href="https://www.washingtonpost.com/wp-dyn/content/article/2005/06/25/AR2005062500982.html">"Psychiatry's Missing Diagnosis: Patients' Diversity Is Often Discounted"</a>. <i><a href="/wiki/The_Washington_Post" title="The Washington Post">The Washington Post</a></i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Washington+Post&rft.atitle=Psychiatry%27s+Missing+Diagnosis%3A+Patients%27+Diversity+Is+Often+Discounted&rft.date=2005-06-26&rft.aulast=Vedantam&rft.aufirst=S&rft_id=https%3A%2F%2Fwww.washingtonpost.com%2Fwp-dyn%2Fcontent%2Farticle%2F2005%2F06%2F25%2FAR2005062500982.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-147"><span class="mw-cite-backlink"><b><a href="#cite_ref-147">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSashidharanFrancis1999" class="citation journal cs1">Sashidharan SP, Francis E (July 1999). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116337">"Racism in psychiatry necessitates reappraisal of general procedures and Eurocentric theories"</a>. <i>BMJ</i>. <b>319</b> (7204): 254. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.319.7204.254">10.1136/bmj.319.7204.254</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116337">1116337</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10417096">10417096</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=BMJ&rft.atitle=Racism+in+psychiatry+necessitates+reappraisal+of+general+procedures+and+Eurocentric+theories&rft.volume=319&rft.issue=7204&rft.pages=254&rft.date=1999-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1116337%23id-name%3DPMC&rft_id=info%3Apmid%2F10417096&rft_id=info%3Adoi%2F10.1136%2Fbmj.319.7204.254&rft.aulast=Sashidharan&rft.aufirst=SP&rft.au=Francis%2C+E&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1116337&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-148"><span class="mw-cite-backlink"><b><a href="#cite_ref-148">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKleinman1997" class="citation journal cs1">Kleinman A (1997). "Triumph or pyrrhic victory? The inclusion of culture in DSM-IV". <i>Harvard Review of Psychiatry</i>. <b>4</b> (6): 343–344. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3109%2F10673229709030563">10.3109/10673229709030563</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9385013">9385013</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:43256486">43256486</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Harvard+Review+of+Psychiatry&rft.atitle=Triumph+or+pyrrhic+victory%3F+The+inclusion+of+culture+in+DSM-IV&rft.volume=4&rft.issue=6&rft.pages=343-344&rft.date=1997&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A43256486%23id-name%3DS2CID&rft_id=info%3Apmid%2F9385013&rft_id=info%3Adoi%2F10.3109%2F10673229709030563&rft.aulast=Kleinman&rft.aufirst=A&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-149"><span class="mw-cite-backlink"><b><a href="#cite_ref-149">^</a></b></span> <span class="reference-text">Bhugra, D. & Munro, A. (1997) <i>Troublesome Disguises: Underdiagnosed Psychiatric Syndromes</i> Blackwell Science Ltd <sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="Please supply an ISBN for this book. (August 2016)">ISBN missing</span></a></i>]</sup></span>
</li>
<li id="cite_note-150"><span class="mw-cite-backlink"><b><a href="#cite_ref-150">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFIreneAzibo1991" class="citation journal cs1">Irene A, Azibo DA (1991). "Diagnosing personality disorder in Africans (Blacks) using the Azibo nosology: Two case studies". <i>Journal of Black Psychology</i>. <b>17</b> (2): 1–22. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F00957984910172002">10.1177/00957984910172002</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:144458287">144458287</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Black+Psychology&rft.atitle=Diagnosing+personality+disorder+in+Africans+%28Blacks%29+using+the+Azibo+nosology%3A+Two+case+studies&rft.volume=17&rft.issue=2&rft.pages=1-22&rft.date=1991&rft_id=info%3Adoi%2F10.1177%2F00957984910172002&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A144458287%23id-name%3DS2CID&rft.aulast=Irene&rft.aufirst=A&rft.au=Azibo%2C+DA&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-151"><span class="mw-cite-backlink"><b><a href="#cite_ref-151">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFya_Azibo2014" class="citation journal cs1">ya Azibo DA (November 2014). <a rel="nofollow" class="external text" href="http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf">"The Azibo Nosology II: Epexegesis and 25th Anniversary Update: 55 Culture-focused Mental Disorders Suffered by African Descent People"</a> <span class="cs1-format">(PDF)</span>. <i>Journal of Pan African Studies</i>. <b>7</b> (5): 32–176. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20151121133043/http://www.jpanafrican.org/docs/vol7no5/4-Nov-Azibo-Noso.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on November 21, 2015.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Pan+African+Studies&rft.atitle=The+Azibo+Nosology+II%3A+Epexegesis+and+25th+Anniversary+Update%3A+55+Culture-focused+Mental+Disorders+Suffered+by+African+Descent+People&rft.volume=7&rft.issue=5&rft.pages=32-176&rft.date=2014-11&rft.aulast=ya+Azibo&rft.aufirst=DA&rft_id=http%3A%2F%2Fwww.jpanafrican.org%2Fdocs%2Fvol7no5%2F4-Nov-Azibo-Noso.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-152"><span class="mw-cite-backlink"><b><a href="#cite_ref-152">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFZulu" class="citation journal cs1">Zulu IM. <a rel="nofollow" class="external text" href="http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf">"The Azibo Nosology: An Interview with Daudi Ajani ya Azibo"</a> <span class="cs1-format">(PDF)</span>. <i>Journal of Pan African Studies</i>. <b>7</b> (5): 209–214. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160820114756/http://www.jpanafrican.org/docs/vol7no5/12-Nov-Azibo-Zulu.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on August 20, 2016.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Pan+African+Studies&rft.atitle=The+Azibo+Nosology%3A+An+Interview+with+Daudi+Ajani+ya+Azibo&rft.volume=7&rft.issue=5&rft.pages=209-214&rft.aulast=Zulu&rft.aufirst=IM&rft_id=http%3A%2F%2Fwww.jpanafrican.org%2Fdocs%2Fvol7no5%2F12-Nov-Azibo-Zulu.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-153"><span class="mw-cite-backlink"><b><a href="#cite_ref-153">^</a></b></span> <span class="reference-text">
<link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFChandler2012" class="citation journal cs1">Chandler E (September 2012). "Religious and spiritual issues in DSM-5: matters of the mind and searching of the soul". <i>Issues in Mental Health Nursing</i>. <b>33</b> (9): 577–582. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3109%2F01612840.2012.704130">10.3109/01612840.2012.704130</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22957950">22957950</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:3453154">3453154</a>. <q>Given the important role that spirituality and religion play for many people in the experiences of coping with health and illness, it seems odd that such important elements are in the margins of the powerful and commanding nosology of the DSM. Explanations for understanding the glaring absence are complex and impacted by some very powerful political and sociological forces, including contributory elements from within the mental health disciplines. This article invites the reader to explore salient issues in the emergence of a broader recognition of religion, spirituality and psychiatric diagnosis in the DSM-5.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Issues+in+Mental+Health+Nursing&rft.atitle=Religious+and+spiritual+issues+in+DSM-5%3A+matters+of+the+mind+and+searching+of+the+soul&rft.volume=33&rft.issue=9&rft.pages=577-582&rft.date=2012-09&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A3453154%23id-name%3DS2CID&rft_id=info%3Apmid%2F22957950&rft_id=info%3Adoi%2F10.3109%2F01612840.2012.704130&rft.aulast=Chandler&rft.aufirst=E&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-154"><span class="mw-cite-backlink"><b><a href="#cite_ref-154">^</a></b></span> <span class="reference-text">Healy D (2006) <a rel="nofollow" class="external text" href="http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030185&ct=1">The Latest Mania: Selling Bipolar Disorder</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20090212110644/http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0030185&ct=1">Archived</a> 2009-02-12 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> PLoS Med 3(4): e185.</span>
</li>
<li id="cite_note-155"><span class="mw-cite-backlink"><b><a href="#cite_ref-155">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCosgroveKrimskyVijayaraghavanSchneider2006" class="citation journal cs1">Cosgrove L, Krimsky S, Vijayaraghavan M, Schneider L (2006). "Financial ties between DSM-IV panel members and the pharmaceutical industry". <i>Psychotherapy and Psychosomatics</i>. <b>75</b> (3): 154–160. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000091772">10.1159/000091772</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16636630">16636630</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:11909535">11909535</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychotherapy+and+Psychosomatics&rft.atitle=Financial+ties+between+DSM-IV+panel+members+and+the+pharmaceutical+industry&rft.volume=75&rft.issue=3&rft.pages=154-160&rft.date=2006&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A11909535%23id-name%3DS2CID&rft_id=info%3Apmid%2F16636630&rft_id=info%3Adoi%2F10.1159%2F000091772&rft.aulast=Cosgrove&rft.aufirst=L&rft.au=Krimsky%2C+S&rft.au=Vijayaraghavan%2C+M&rft.au=Schneider%2C+L&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-156"><span class="mw-cite-backlink"><b><a href="#cite_ref-156">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20170626220701/http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html">"(Susan Bowman, 2006)"</a>. The National Psychologist. November 1, 2006. Archived from <a rel="nofollow" class="external text" href="http://nationalpsychologist.com/2006/11/glasser-headlines-psychotherapy-conference/10879.html">the original</a> on June 26, 2017<span class="reference-accessdate">. Retrieved <span class="nowrap">December 3,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=%28Susan+Bowman%2C+2006%29&rft.pub=The+National+Psychologist&rft.date=2006-11-01&rft_id=http%3A%2F%2Fnationalpsychologist.com%2F2006%2F11%2Fglasser-headlines-psychotherapy-conference%2F10879.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Greenberg-157"><span class="mw-cite-backlink"><b><a href="#cite_ref-Greenberg_157-0">^</a></b></span> <span class="reference-text">
<link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGreenberg2012" class="citation news cs1">Greenberg G (January 29, 2012). <a rel="nofollow" class="external text" href="https://www.nytimes.com/2012/01/30/opinion/the-dsms-troubled-revision.html">"The D.S.M.'s Troubled Revision"</a>. <i>The New York Times</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+York+Times&rft.atitle=The+D.S.M.%27s+Troubled+Revision&rft.date=2012-01-29&rft.aulast=Greenberg&rft.aufirst=G&rft_id=https%3A%2F%2Fwww.nytimes.com%2F2012%2F01%2F30%2Fopinion%2Fthe-dsms-troubled-revision.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span> The article's closing words: "it [the APA] will be laughing all the way to the bank."</span>
</li>
<li id="cite_note-158"><span class="mw-cite-backlink"><b><a href="#cite_ref-158">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFGilesNewbold2011" class="citation journal cs1">Giles DC, Newbold J (March 2011). <a rel="nofollow" class="external text" href="http://journals.sagepub.com/doi/10.1177/1049732310381388">"Self- and Other-Diagnosis in User-Led Mental Health Online Communities"</a>. <i>Qualitative Health Research</i>. <b>21</b> (3): 419–428. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F1049732310381388">10.1177/1049732310381388</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://www.worldcat.org/issn/1049-7323">1049-7323</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20739589">20739589</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:1853974">1853974</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Qualitative+Health+Research&rft.atitle=Self-+and+Other-Diagnosis+in+User-Led+Mental+Health+Online+Communities&rft.volume=21&rft.issue=3&rft.pages=419-428&rft.date=2011-03&rft.issn=1049-7323&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A1853974%23id-name%3DS2CID&rft_id=info%3Apmid%2F20739589&rft_id=info%3Adoi%2F10.1177%2F1049732310381388&rft.aulast=Giles&rft.aufirst=DC&rft.au=Newbold%2C+J&rft_id=http%3A%2F%2Fjournals.sagepub.com%2Fdoi%2F10.1177%2F1049732310381388&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Sane-159"><span class="mw-cite-backlink"><b><a href="#cite_ref-Sane_159-0">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf">Sanism in Theory and Practice</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20140317045503/http://www.socialinequities.ca/wordpress/wp-content/uploads/2011/07/Ingram.Sanism-in-Theory-and-Practice.CI_.2011.pdf">Archived</a> 2014-03-17 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> May 9/10, 2011. Richard Ingram, Centre for the Study of Gender, Social Inequities and Mental Health. <a href="/wiki/Simon_Fraser_University" title="Simon Fraser University">Simon Fraser University</a>, Canada</span>
</li>
<li id="cite_note-160"><span class="mw-cite-backlink"><b><a href="#cite_ref-160">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="http://jhp.sagepub.com/cgi/content/abstract/41/4/36">"How Using the Dsm Causes Damage: A Client's Report"</a> <i>Journal of Humanistic Psychology</i>, Vol. 41, No. 4, 36–56 (2001)</span>
</li>
<li id="cite_note-CapeTown-161"><span class="mw-cite-backlink"><b><a href="#cite_ref-CapeTown_161-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFCape_Town_Mad_Pride2013" class="citation web cs1"><a href="/wiki/Mad_Pride" class="mw-redirect" title="Mad Pride">Cape Town Mad Pride</a> (June 8, 2013). <a rel="nofollow" class="external text" href="https://madpridect.wordpress.com/2013/06/08/known-as-the-psychiatric-bible-the-diagnostic-and-statistical-manual-of-mental-disorders-appears-in-a-fifth-edition/">"Known as the 'psychiatric bible', the Diagnostic and Statistical Manual of Mental Disorders appears in a fifth edition"</a><span class="reference-accessdate">. Retrieved <span class="nowrap">February 28,</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Known+as+the+%27psychiatric+bible%27%2C+the+Diagnostic+and+Statistical+Manual+of+Mental+Disorders+appears+in+a+fifth+edition&rft.date=2013-06-08&rft.au=Cape+Town+Mad+Pride&rft_id=https%3A%2F%2Fmadpridect.wordpress.com%2F2013%2F06%2F08%2Fknown-as-the-psychiatric-bible-the-diagnostic-and-statistical-manual-of-mental-disorders-appears-in-a-fifth-edition%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Medscape-162"><span class="mw-cite-backlink">^ <a href="#cite_ref-Medscape_162-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Medscape_162-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">
Michael T. Compton (2007) <a rel="nofollow" class="external text" href="http://www.medscape.com/viewarticle/565489_print">Recovery: Patients, Families, Communities</a> Conference Report, Medscape Psychiatry & Mental Health, October 11–14, 2007</span>
</li>
<li id="cite_note-nyt-163"><span class="mw-cite-backlink"><b><a href="#cite_ref-nyt_163-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFrances2012" class="citation news cs1">Frances A (May 11, 2012). <a rel="nofollow" class="external text" href="https://www.nytimes.com/2012/05/12/opinion/break-up-the-psychiatric-monopoly.html">"Diagnosing the D.S.M."</a> <i>New York Times</i> (New York ed.). p. A19.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=New+York+Times&rft.atitle=Diagnosing+the+D.S.M.&rft.pages=A19&rft.date=2012-05-11&rft.aulast=Frances&rft.aufirst=A&rft_id=https%3A%2F%2Fwww.nytimes.com%2F2012%2F05%2F12%2Fopinion%2Fbreak-up-the-psychiatric-monopoly.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-dsm5GuideNotBible-164"><span class="mw-cite-backlink">^ <a href="#cite_ref-dsm5GuideNotBible_164-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-dsm5GuideNotBible_164-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFFrances2012" class="citation web cs1">Frances AJ (December 2, 2012). <a rel="nofollow" class="external text" href="http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes">"DSM 5 Is Guide Not Bible – Ignore Its Ten Worst Changes: APA approval of DSM-5 is a sad day for psychiatry"</a>. <i>Psychology Today</i><span class="reference-accessdate">. Retrieved <span class="nowrap">March 9,</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Psychology+Today&rft.atitle=DSM+5+Is+Guide+Not+Bible+%26ndash%3B%26%2332%3BIgnore+Its+Ten+Worst+Changes%3A+APA+approval+of+DSM-5+is+a+sad+day+for+psychiatry&rft.date=2012-12-02&rft.aulast=Frances&rft.aufirst=AJ&rft_id=http%3A%2F%2Fwww.psychologytoday.com%2Fblog%2Fdsm5-in-distress%2F201212%2Fdsm-5-is-guide-not-bible-ignore-its-ten-worst-changes&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-Phillips-165"><span class="mw-cite-backlink"><b><a href="#cite_ref-Phillips_165-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFPhillipsFrancesCerulloChardavoyne2012" class="citation journal cs1">Phillips J, Frances A, Cerullo MA, Chardavoyne J, Decker HS, First MB, et al. (January 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305603">"The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis"</a>. <i>Philosophy, Ethics, and Humanities in Medicine</i>. <b>7</b> (1): 3. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1186%2F1747-5341-7-3">10.1186/1747-5341-7-3</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305603">3305603</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22243994">22243994</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Philosophy%2C+Ethics%2C+and+Humanities+in+Medicine&rft.atitle=The+six+most+essential+questions+in+psychiatric+diagnosis%3A+a+pluralogue+part+1%3A+conceptual+and+definitional+issues+in+psychiatric+diagnosis&rft.volume=7&rft.issue=1&rft.pages=3&rft.date=2012-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3305603%23id-name%3DPMC&rft_id=info%3Apmid%2F22243994&rft_id=info%3Adoi%2F10.1186%2F1747-5341-7-3&rft.aulast=Phillips&rft.aufirst=J&rft.au=Frances%2C+A&rft.au=Cerullo%2C+MA&rft.au=Chardavoyne%2C+J&rft.au=Decker%2C+HS&rft.au=First%2C+MB&rft.au=Ghaemi%2C+N&rft.au=Greenberg%2C+G&rft.au=Hinderliter%2C+AC&rft.au=Kinghorn%2C+WA&rft.au=LoBello%2C+SG&rft.au=Martin%2C+EB&rft.au=Mishara%2C+AL&rft.au=Paris%2C+J&rft.au=Pierre%2C+JM&rft.au=Pies%2C+RW&rft.au=Pincus%2C+HA&rft.au=Porter%2C+D&rft.au=Pouncey%2C+C&rft.au=Schwartz%2C+MA&rft.au=Szasz%2C+T&rft.au=Wakefield%2C+JC&rft.au=Waterman%2C+GS&rft.au=Whooley%2C+O&rft.au=Zachar%2C+P&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3305603&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-pointpark-166"><span class="mw-cite-backlink">^ <a href="#cite_ref-pointpark_166-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-pointpark_166-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20120329184708/http://www.pointpark.edu/NewsArtsSciences.aspx?id=467">"Professor co-authors letter about America's mental health manual"</a>. <i>Point Park University</i>. December 12, 2011. Archived from <a rel="nofollow" class="external text" href="http://www.pointpark.edu/NewsArtsSciences.aspx?id=467">the original</a> on March 29, 2012<span class="reference-accessdate">. Retrieved <span class="nowrap">April 4,</span> 2012</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Point+Park+University&rft.atitle=Professor+co-authors+letter+about+America%27s+mental+health+manual&rft.date=2011-12-12&rft_id=http%3A%2F%2Fwww.pointpark.edu%2FNewsArtsSciences.aspx%3Fid%3D467&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
<li id="cite_note-167"><span class="mw-cite-backlink"><b><a href="#cite_ref-167">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFAllday2011" class="citation news cs1">Allday E (November 26, 2011). <a rel="nofollow" class="external text" href="http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/26/MNJJ1M3DFK.DTL">"Revision of psychiatric manual under fire"</a>. <i>San Francisco Chronicle</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=San+Francisco+Chronicle&rft.atitle=Revision+of+psychiatric+manual+under+fire&rft.date=2011-11-26&rft.aulast=Allday&rft.aufirst=E&rft_id=http%3A%2F%2Fwww.sfgate.com%2Fcgi-bin%2Farticle.cgi%3Ff%3D%2Fc%2Fa%2F2011%2F11%2F26%2FMNJJ1M3DFK.DTL&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></span>
</li>
</ol></div>
<h2><span class="mw-headline" id="Further_reading">Further reading</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=38" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<style data-mw-deduplicate="TemplateStyles:r1054258005">.mw-parser-output .refbegin{font-size:90%;margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}</style><div class="refbegin" style="">
<ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFAmerican_Psychiatric_Association2000" class="citation book cs1">American Psychiatric Association (2000). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=3SQrtpnHb9MC"><i>Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®</i></a>. American Psychiatric Pub. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-89042-025-6" title="Special:BookSources/978-0-89042-025-6"><bdi>978-0-89042-025-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Diagnostic+and+Statistical+Manual+of+Mental+Disorders%2C+Fourth+Edition%3A+DSM-IV-TR%C2%AE&rft.pub=American+Psychiatric+Pub&rft.date=2000&rft.isbn=978-0-89042-025-6&rft.au=American+Psychiatric+Association&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D3SQrtpnHb9MC&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></li>
<li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSpitzer2002" class="citation book cs1">Spitzer RL (2002). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=S_xe-AX4UjMC"><i>Dsm-Iv-Tr Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders</i></a>. American Psychiatric Pub. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-58562-059-3" title="Special:BookSources/978-1-58562-059-3"><bdi>978-1-58562-059-3</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Dsm-Iv-Tr+Casebook%3A+A+Learning+Companion+to+the+Diagnostic+and+Statistical+Manual+of+Mental+Disorders&rft.pub=American+Psychiatric+Pub&rft.date=2002&rft.isbn=978-1-58562-059-3&rft.aulast=Spitzer&rft.aufirst=RL&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DS_xe-AX4UjMC&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiagnostic+and+Statistical+Manual+of+Mental+Disorders" class="Z3988"></span></li></ul>
</div>
<h2><span class="mw-headline" id="External_links">External links</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diagnostic_and_Statistical_Manual_of_Mental_Disorders&action=edit&section=39" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<ul><li><a rel="nofollow" class="external text" href="http://www.dsm5.org/pages/default.aspx">Official DSM-5 development website</a></li>
<li><a rel="nofollow" class="external text" href="https://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm">Diagnostic Criteria from DSM-IV-TR</a><sup class="noprint Inline-Template"><span style="white-space: nowrap;">[<i><a href="/wiki/Wikipedia:Link_rot" title="Wikipedia:Link rot"><span title=" Dead link tagged December 2021">dead link</span></a></i>]</span></sup></li>
<li><a rel="nofollow" class="external text" href="https://archive.today/20120527015056/http://www.behavenet.com/capsules/disorders/dsm4TRclassification.htm">Diagnostic Criteria from DSM-IV-TR</a></li>
<li><a rel="nofollow" class="external text" href="https://apicalhealth.com/illness-and-recovery/dsm-iv/">The Multiaxial System of Diagnosis in DSM-IV Criteria</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210116142849/https://apicalhealth.com/illness-and-recovery/dsm-iv/">Archived</a> 2021-01-16 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li></ul>
<div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><style data-mw-deduplicate="TemplateStyles:r1061467846">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output .navbox-list-with-group{text-align:left;border-left-width:2px;border-left-style:solid}.mw-parser-output tr+tr>.navbox-abovebelow,.mw-parser-output tr+tr>.navbox-group,.mw-parser-output tr+tr>.navbox-image,.mw-parser-output tr+tr>.navbox-list{border-top:2px solid #fdfdfd}.mw-parser-output .navbox-title{background-color:#ccf}.mw-parser-output .navbox-abovebelow,.mw-parser-output .navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}</style></div><div role="navigation" class="navbox" aria-labelledby="Personality_disorder_classification" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1063604349">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Personality_disorder_classification" title="Template:Personality disorder classification"><abbr title="View this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Personality_disorder_classification" title="Template talk:Personality disorder classification"><abbr title="Discuss this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Personality_disorder_classification" title="Special:EditPage/Template:Personality disorder classification"><abbr title="Edit this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">e</abbr></a></li></ul></div><div id="Personality_disorder_classification" style="font-size:114%;margin:0 4em"><a href="/wiki/Personality_disorder#Diagnosis" title="Personality disorder">Personality disorder classification</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">General classifications</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Dimensional_models_of_personality_disorders" title="Dimensional models of personality disorders">Dimensional</a></li>
<li><a class="mw-selflink-fragment" href="#DSM-IV-TR_.282000.29">Categorical</a></li>
<li><a class="mw-selflink-fragment" href="#Multi-axial_system">Multi-axial</a></li>
<li><a href="/wiki/Prototype" title="Prototype">Prototypal</a></li>
<li><a href="/w/index.php?title=Relational_classification_of_personality_disorders&action=edit&redlink=1" class="new" title="Relational classification of personality disorders (page does not exist)">Relational</a></li>
<li><a href="/w/index.php?title=Structural_classification_of_personality_disorders&action=edit&redlink=1" class="new" title="Structural classification of personality disorders (page does not exist)">Structural</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Diseases" title="International Classification of Diseases">ICD</a> classifications (<a href="/wiki/ICD-10" title="ICD-10">ICD-10</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Schizotypal</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Schizotypal_personality_disorder#ICD" title="Schizotypal personality disorder">Schizotypal</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Specific</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Obsessive-compulsive_personality_disorder#WHO" class="mw-redirect" title="Obsessive-compulsive personality disorder">Anankastic</a></li>
<li><a href="/wiki/Avoidant_personality_disorder" title="Avoidant personality disorder">Anxious (avoidant)</a></li>
<li><a href="/wiki/Dependent_personality_disorder" title="Dependent personality disorder">Dependent</a></li>
<li><a href="/wiki/Antisocial_personality_disorder#ICD-10" title="Antisocial personality disorder">Dissocial</a></li>
<li><a href="/wiki/Emotionally_unstable_personality_disorder" class="mw-redirect" title="Emotionally unstable personality disorder">Emotionally unstable</a></li>
<li><a href="/wiki/Histrionic_personality_disorder" title="Histrionic personality disorder">Histrionic</a></li>
<li><a href="/wiki/Paranoid_personality_disorder" title="Paranoid personality disorder">Paranoid</a></li>
<li><a href="/wiki/Schizoid_personality_disorder" title="Schizoid personality disorder">Schizoid</a></li>
<li class="mw-empty-elt"></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: LemonChiffon;">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Eccentricity_(behavior)" title="Eccentricity (behavior)">Eccentric</a></li>
<li><a href="/wiki/Haltlose_personality_disorder" title="Haltlose personality disorder">Haltlose</a></li>
<li><a href="/wiki/Immature_personality_disorder" title="Immature personality disorder">Immature</a></li>
<li><a href="/wiki/Narcissistic_personality_disorder" title="Narcissistic personality disorder">Narcissistic</a></li>
<li><a href="/wiki/Passive%E2%80%93aggressive_personality_disorder" title="Passive–aggressive personality disorder">Passive–aggressive</a></li>
<li><a href="/wiki/Neurosis" title="Neurosis">Psychoneurotic</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Organic</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Organic_personality_disorder" title="Organic personality disorder">Organic</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Unspecified</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Personality_disorder_not_otherwise_specified" title="Personality disorder not otherwise specified">Unspecified</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink selflink">DSM</a> classifications</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="DSM-III-R_only" scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink-fragment" href="#DSM-III_.281980.29">DSM-III-R</a> only</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Sadistic_personality_disorder" title="Sadistic personality disorder">Sadistic</a></li>
<li><a href="/wiki/Self-defeating_personality_disorder" title="Self-defeating personality disorder">Self-defeating (masochistic)</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink-fragment" href="#DSM-IV_.281994.29">DSM-IV</a> only</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/wiki/Personality_disorder_not_otherwise_specified" title="Personality disorder not otherwise specified">Personality disorder not otherwise specified</a>
</div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: LemonChiffon"><a href="/wiki/Personality_disorder#Appendix_B:_Criteria_Sets_and_Axes_Provided_for_Further_Study" title="Personality disorder">Appendix B (proposed)</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Depressive_personality_disorder" title="Depressive personality disorder">Depressive</a></li>
<li><a href="/wiki/Passive%E2%80%93aggressive_personality_disorder" title="Passive–aggressive personality disorder">Negativistic (passive–aggressive)</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DSM-5" title="DSM-5">DSM-5</a><br />(Categorical<br />model)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background-color: LemonChiffon"><a href="/wiki/Personality_disorder#Cluster_A_.28odd_or_eccentric_disorders.29" title="Personality disorder">Cluster A (odd)</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Paranoid_personality_disorder" title="Paranoid personality disorder">Paranoid</a></li>
<li><a href="/wiki/Schizoid_personality_disorder" title="Schizoid personality disorder">Schizoid</a></li>
<li><a href="/wiki/Schizotypal_personality_disorder" title="Schizotypal personality disorder">Schizotypal</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: LemonChiffon"><a href="/wiki/Personality_disorder#Cluster_B_.28dramatic.2C_emotional_or_erratic_disorders.29" title="Personality disorder">Cluster B (dramatic)</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Antisocial_personality_disorder" title="Antisocial personality disorder">Antisocial</a></li>
<li><a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">Borderline</a></li>
<li><a href="/wiki/Histrionic_personality_disorder" title="Histrionic personality disorder">Histrionic</a></li>
<li><a href="/wiki/Narcissistic_personality_disorder" title="Narcissistic personality disorder">Narcissistic</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background-color: LemonChiffon"><a href="/wiki/Personality_disorder#Cluster_C_.28anxious_or_fearful_disorders.29" title="Personality disorder">Cluster C (anxious)</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Avoidant_personality_disorder" title="Avoidant personality disorder">Avoidant</a></li>
<li><a href="/wiki/Dependent_personality_disorder" title="Dependent personality disorder">Dependent</a></li>
<li><a href="/wiki/Obsessive%E2%80%93compulsive_personality_disorder" title="Obsessive–compulsive personality disorder">Obsessive-compulsive</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DSM-5" title="DSM-5">DSM-5</a><br />(Alternative<br />model)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/w/index.php?title=Personality_disorder_trait_specified&action=edit&redlink=1" class="new" title="Personality disorder trait specified (page does not exist)">Trait specified</a>
</div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"></table><div></div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>
<div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1061467846"></div><div role="navigation" class="navbox" aria-labelledby="Medical_classification" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1063604349"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Medical_classification" title="Template:Medical classification"><abbr title="View this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Medical_classification" title="Template talk:Medical classification"><abbr title="Discuss this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Medical_classification" title="Special:EditPage/Template:Medical classification"><abbr title="Edit this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">e</abbr></a></li></ul></div><div id="Medical_classification" style="font-size:114%;margin:0 4em"><a href="/wiki/Medical_classification" title="Medical classification">Medical classification</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Topographical_code" title="Topographical code">Topographical codes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Federative_International_Committee_on_Anatomical_Terminology" class="mw-redirect" title="Federative International Committee on Anatomical Terminology">Terminologia</a>
<ul><li><a href="/wiki/Terminologia_Anatomica" title="Terminologia Anatomica">TA</a></li>
<li><a href="/wiki/Terminologia_Histologica" title="Terminologia Histologica">TH</a></li>
<li><a href="/wiki/Terminologia_Embryologica" title="Terminologia Embryologica">TE</a></li></ul></li>
<li><a href="/wiki/Systematized_Nomenclature_of_Medicine#T_(Topography)_--_Anatomic_terms" title="Systematized Nomenclature of Medicine">SNOMED T axis</a></li>
<li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH A axis</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Diagnosis_code" title="Diagnosis code">Diagnostic codes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>general:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/International_Classification_of_Diseases" title="International Classification of Diseases">ICD</a>
<ul><li><a href="/wiki/ICD-11" title="ICD-11">11</a></li>
<li><a href="/wiki/ICD-10" title="ICD-10">10</a></li>
<li><a href="/wiki/ICD-9" class="mw-redirect" title="ICD-9">9</a></li></ul></li>
<li><a href="/wiki/International_Classification_of_Primary_Care" title="International Classification of Primary Care">ICPC-2</a></li>
<li><a href="https://fr.wikipedia.org/wiki/Dictionnaire_des_r%C3%A9sultats_de_consultation" class="extiw" title="fr:Dictionnaire des résultats de consultation">DRC</a></li>
<li><a href="/wiki/NANDA" class="mw-redirect" title="NANDA">NANDA</a></li>
<li><a href="/wiki/Read_code" title="Read code">Read codes</a></li>
<li><a href="/wiki/Systematized_Nomenclature_of_Medicine" title="Systematized Nomenclature of Medicine">SNOMED D axis</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>specialized:</i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/International_Classification_of_Diseases_for_Oncology" title="International Classification of Diseases for Oncology">ICD-O</a></li>
<li><a href="/wiki/International_Classification_of_Sleep_Disorders" title="International Classification of Sleep Disorders">ICSD</a></li>
<li><a href="/wiki/International_Classification_of_Headache_Disorders" title="International Classification of Headache Disorders">ICHD</a></li>
<li><a href="/wiki/The_International_League_of_Dermatological_Societies" title="The International League of Dermatological Societies">ILDS</a></li>
<li><a class="mw-selflink selflink">DSM</a>
<ul><li><a href="/wiki/DSM-IV_codes" class="mw-redirect" title="DSM-IV codes">IV</a></li>
<li><a href="/wiki/DSM-5" title="DSM-5">5</a></li></ul></li>
<li><a href="/wiki/British_Pediatric_Association_Classification_of_Diseases" title="British Pediatric Association Classification of Diseases">BPA</a></li>
<li><a href="/wiki/Chinese_Classification_of_Mental_Disorders" title="Chinese Classification of Mental Disorders">CCMD-3</a></li>
<li><a href="/wiki/Orchard_Sports_Injury_and_Illness_Classification_System_(OSIICS)" class="mw-redirect" title="Orchard Sports Injury and Illness Classification System (OSIICS)">OSIICS</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Procedure_code" title="Procedure code">Procedural codes</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Healthcare_Common_Procedure_Coding_System" title="Healthcare Common Procedure Coding System">HCPCS</a> (<a href="/wiki/Current_Procedural_Terminology" title="Current Procedural Terminology">CPT</a>, <a href="/wiki/HCPCS_Level_2" title="HCPCS Level 2">Level 2</a>)</li>
<li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>
<ul><li><a href="/wiki/ICD-10_Procedure_Coding_System" title="ICD-10 Procedure Coding System">10 PCS</a></li>
<li><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">9-CM Volume 3</a></li>
<li><a href="/wiki/International_Classification_of_Health_Interventions" title="International Classification of Health Interventions">ICHI</a></li></ul></li>
<li><a href="/wiki/Nursing_Interventions_Classification" title="Nursing Interventions Classification">NIC</a></li>
<li><a href="/wiki/Systematized_Nomenclature_of_Medicine" title="Systematized Nomenclature of Medicine">SNOMED P axis</a></li>
<li><a href="/wiki/OPS-301" title="OPS-301">OPS-301</a></li>
<li><a href="/wiki/Read_code" title="Read code">Read codes</a>/<a href="/wiki/OPCS-4" title="OPCS-4">OPCS-4</a></li>
<li><a href="/wiki/Classification_Commune_des_Actes_M%C3%A9dicaux" title="Classification Commune des Actes Médicaux">CCAM</a></li>
<li><a href="/wiki/LOINC" title="LOINC">LOINC</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pharmaceutical_code" title="Pharmaceutical code">Pharmaceutical codes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC</a></li>
<li><a href="/wiki/National_drug_code" title="National drug code">NDC</a></li>
<li><a href="/wiki/Systematized_Nomenclature_of_Medicine" title="Systematized Nomenclature of Medicine">SNOMED C axis</a></li>
<li><a href="/wiki/Drug_Identification_Number" class="mw-redirect" title="Drug Identification Number">DIN</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Outcomes codes</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Nursing_Outcomes_Classification" title="Nursing Outcomes Classification">NOC</a></li></ul>
</div></td></tr></tbody></table></div></div>' |
Whether or not the change was made through a Tor exit node (tor_exit_node) | false |
Unix timestamp of change (timestamp) | '1714263726' |
