
The DSM is not at its 5th edition
Robert Spitzer, father of psychiatric diagnosis, dies at 83 in an assisted living facility in Seattle.
Dr. Spitzer is the author of the first Diagnostic and Statistical Manual (DSM) of mental disorders. He is the one who provided a framework for diagnosis in the field of psychiatry, as well as a guideline for research and legal judgments. His work came to put an end to the endless debate between normal and abnormal behavior.
Dr. Spitzer redesigned psychiatry as a science in a time when it was fighting to keep its credibility, during the 1960s. At that time diagnosis wasn’t a stable science as it used to differ from doctor to doctor – as one doctor was diagnosing someone with depression, other doctor could say that person has anxiety and another one that they’re neurotic.
The diagnostic manual at that time was more of a pamphlet-like document designed on Freudian ideas which was very debatable, leaving the opportunity for each doctor to set the diagnosis according to their own judgment.
At that time Spitzer was a researcher at Columbia University, more and more frustrated by the role of Freudian analysis in psychiatry and diagnosis. The faith made him meet a colleague who was working on the new edition of DSM. That’s how he got a job – taking notes for the committee which was debating the revisions – where he learned of assessment of symptoms and behavior.
In the beginning of his career in assessing mental illnesses, one of the first behaviors he started scrutinizing was homosexuality. At that time, homosexuality was considered a mental disorder and this is how it appeared in the first editions of DSM.
After meeting different gay people and gay advocates Dr. Spitzer has re-analyzed homosexuality observing that it was not causing measurable distress. This is what led to the condition called “sexual orientation disturbance” to be described, since 1973, as a condition which was causing distress to both homo- and heterosexuals.
Dr. Spitzer was then put in charge of the third revision of the manual, DSM3, for which he applied the same question – does it cause distress? – to re-examine all the behavioral conditions listed in the manual.
DSM3 changed the face of psychiatry forever, becoming the manual of reference for every research that fallowed. It was the first diagnosis manual which used checklists for every condition listed, making it more exact and easier for doctors to recognize conditions and diagnose patients.
Image source: wikipedia
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