History of Psychiatric Diagnoses - Boulger

Question 1

When were psychiatric syndromes first classified?

Answer 1

• 1500 BC - Ebers papyrus - described depression and dementia
• 460 BC - Hippocrates - described depression, mania, delirium, & hysteria
• 200 AD - Galen - mental illness due to imbalances of “humors”
• 1550 AD - Enlightenment → order/classification in all matters of science including medicine

Question 2

What famous quote did René Descartes use to describe his idea of distint dualism in humans (mind/body dichotomy) that we continue to see in many writings today?

Answer 2

“I think, therefore I am.”

Question 3

What governmental branched pushed to create its own system of classification for mental illness to meet the needs of psychiatrists?

Answer 3

US Military (1940)

Question 4

What organization created the first Diagnostic and Statistical Manual (DSM-I) in reaction to the US Military’s list of mental disorders that was published as “War Department Technical Bulletin 203” ?

Answer 4

The American Psychiatric Association

(132 pages total)

Question 5

When was homosexuality no longer listed as a “disease”? What was the diagnosis replaced with?

Answer 5

1974 DSM-II

“sexual orientation disturbance”

Question 6

What were the four major changes in DSM-III?

Answer 6

• grew to 494 pages
• introduced diagnostic criteria and the multiaxial classification system (axes I-V)
• general definition of mental illness
• ***statistical concept of reliability to the diagnostic process

Question 7

What was the major change in DSM-IV?

Answer 7

• Inclusion of clinical significance criterion to almost half of all categories
  
  • required symptoms to cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning”

Question 8

How many total diagnoses are in DSM-V?

Answer 8

Fewer than 297!

(less than DSM-IV at 297 and DSM-III-R at 292)

Question 9

What are the changes in DSM-5?

Answer 9

• Within a category, specific disorders are arranged so that those typically diagnosed in childhood are listed first
• No use of term “addiction”, instead “use disorder” is preferred
• Elimination of multiaxial diagnostic system
• NOS (Not Otherwise Specified) → NEC (Not Elsewhere Classified)
• NEW diagnostic categories/disorders:
  
  • Obsessive-Compulsive and Related Disorders
  • Trauma and Stressor-Related Disorders

Question 10

What major change was made in relation to Neurodevelopmental Disorders (e.g. mental retardation)?

Answer 10

• Mental retardation → Intellectual disability
  
  • Intellectual Developmental Disorder (IDD)
• No longer uses IQ test scores as the almost sole determinant for inclusion

Question 11

How long did it take to make DSM-5?

Answer 11

14 years

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