How Psychiatry Went Crazy
The "bible" of psychiatric diagnosis shapes—and deforms—both treatment and policy.
At least the Bible lists only 10 Commandments; the DSM grows by leaps and bounds with every revision. The first edition, published by the American Psychiatric Association in 1952, was a spiral-bound pamphlet that described 11 categories of mental disorder, including brain syndromes, personality problems and psychotic disorders. (The final category, "Nondiagnostic Terms for the Hospital Record," contained Dead on Admission, the one diagnosis that psychiatrists have ever agreed on.) The DSM-II (1968) made homosexuality a mental disorder, a decision revoked by vote in 1973. In the general excitement about that progressive decision, few noted that voting didn't seem to be the most scientific way of determining mental illness. Narcissistic Personality Disorder was voted out in 1968 and voted back in 1980; where did it go for 12 years? Doctors don't vote on whether pneumonia is a disease.