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The Diagnostic and Statistical Manual and Mental Disorders (DSM-I) is the first edition of the DSM, introducing a standardised classification of mental disorders.

History

DSM-I was published in 1952 by the American Psychiatric Association (APA). Preceding its publication, its development began during World War II with a classification scheme called Medical 203, created by a committee lead by psychiatrist Brigadier General William C. Menninger, with minor revisions by the US Navy. A modified version of Medical 203 was then adopted by the Veterans Administration.

In 1949, the sixth revision of the International Statistical Classification of Diseases (ICD) was published by the World Health Organization (WHO) and, for the first time, included a section on mental disorders. This section, according the the foreword to the DSM-I, "categorized mental disorders in rubrics similar to those of the Armed Forces nomenclature." Further development of Medical 203 was undertaken to create a version specifically for the United States, and after a few more revisions it was approved for publication in 1951.

Classification

Disorders listed in the DSM-I are classified under the following headings.

Disorders Caused by or Associated With Impairment of Brain Tissue Function

This category lists disorders with an organic origin, and that are characterised by:

  1. Impairment of orientation
  2. Impairment of memory
  3. Impairment of all intellectual functions (comprehension, calculation, knowledge, learning, etc.)
  4. Impairment of judgement
  5. Lability and shallowness of affect

These disorders are further separated into two distinct categories:

  1. Acute Brain Disorders
  2. Chronic Brain Disorders

These categories separate disorders primarily based on the reversibility of the symptoms of the disorder and its organic cause. Since one aetiology may be capable of producing both acute and chronic brain disorders, the initial presentation could be diagnosed as acute, only to go on to cause permanent brain damage and to be diagnosed as chronic.

Mental Deficiency

Further reading: Mental deficiency

This category is used to classify a disorder characterised by low intelligence existing since birth that isn't caused by an organic brain disease or a known prenatal cause.

Disorders of Psychogenic Origin or Without Clearly Defined Physical Cause or Structural Change in the Brain

This category includes all disorders not covered by the above categories, and is further divided into the following subcategories:

  1. Psychotic Disorders
    1. Affective reactions
    2. Schizophrenic reactions
    3. Paranoid reactions
    4. Psychotic reaction without clearly defined structural change, other than above
  2. Psychophysiologic Autonomic and Visceral Disorders
  3. Psychoneurotic Disorders
  4. Personality Disorders
    1. Personality pattern disturbance
    2. Personality trait disturbance
    3. Sociopathic personality disturbance
    4. Special symptom reactions
  5. Transient Situational Personality Disorders

Controversy

One of the disorders included in the DSM-I was homosexuality, which sparked controversy amongst the gay and lesbian community.

In 1962, a study was conducted by Irving Bieber, resulting in the publication of Homosexuality: A Psychoanalytic Study of Male Homosexuals. This study suggested that homosexuality resulted from a pathological hidden fear of the opposite sex caused by traumatic parent-child relationships, which became a widely accepted view in the medical community. This was despite a 1956 study by Evelyn Hooker that had found no difference in the happiness and well-adjusted nature of self-identified homosexual men compared to heterosexual men. However, because the National Institute of Mental Health (NIMH) was so impressed with Hooker's work, they granted her the 1961 NIMH Research Career Award to continue her research. Her further studies were paramount in changing the attitudes of the psychological community towards homosexuality, leading it to be removed from the DSM in the second printing of the DSM-II in 1974.