UW News

March 28, 2014

Documents that Changed the World: Mental disorder diagnostic manual, 1952

UW News

The Diagnostic and Statistical Manual of Mental Disorders, informally known as the DSM.Three little words fittingly kick off the latest installment of Joe Janes’ Documents that Changed the World podcast series: “Are you crazy?”

That’s because his topic is the Diagnostic and Statistical Manual of Mental Disorders, informally known as the DSM. Published in 1952 by the American Psychiatric Association, the manual sets classification and diagnosis standards used by clinicians, researchers, regulation agencies and health insurers worldwide.

In the podcast series, Janes, a professor in the UW Information School, explores the origin and often evolving meaning of historical documents both famous and less known. UW Today presents these periodically, and all of the podcasts are available online at the Information School website.

Janes dates the history of such mental health cataloging to the 1840 U.S. Census, the first to try to determine the number of people who were “insane” or “idiotic.”

Documents that Changed the World podcast series:

The actual manual, he says, “started with a thin little spiral-bound volume, very technical and very dry” and has since “changed and grown several times, and which completely changed the way we think about, and talk about, our minds and selves.”

The manual has been revised several times, Janes says, first to the unpopular DSM II in 1968. Subsequent versions “largely repudiate the bases of the previous one, all emerging from a complex stew of forces — scientific, economic, social, cultural and political — that act on it.” The manual’s fifth edition, Janes says, “took 14 years to work through and there’s still great unhappiness about it.”

The manual of mental disorders is also very much a product of its times, socially and politically. The 1952 edition, Janes notes, lists multiple sclerosis, epilepsy and syphilis as “mental diseases,” and “includes some very peculiar language about racial categories.”

Far more extreme is the example of homosexuality, which Janes reports appeared in the 1968 edition “as one of several otherwise undefined ‘sexual deviations’ along with pedophilia, transvestism and voyeurism, nestled snugly between ‘inadequate personality’ and ‘alcoholism’ in the nonpsychotic mental disorders.”

Janes said as he researched he was intrigued “that the revisions have been so contentious and increasingly elongated, very political, and nobody is ever happy with the results, and yet so much hinges on what’s in there and how.

He added, “The more I read about it, the more complicated and instrumental — in both senses of the word — it seemed.”

The Documents that Changed the World podcast series is also available on iTunes, with more than 75,000 downloads there so far.

Previous installments of the “Documents that Changed the World” series