A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice

Translated into over twenty languages, referred to by clinicians from multiple schools, as well as by researchers, policy-makers, criminal courts, and third-party reimbursement entities [1], the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM) enjoys a nearly hegemonic status as the reference for the assessment and categorization of mental disorders of all types - not only in the United States, but increasingly in Europe and more recently Asia. To be sure, the discipline and practice of psychiatry has changed since the first DSM was released, and with the fifth edition (DSM-V) currently in field trials in preparation for general release in spring 2013, there is renewed discussion - and debate - about whether this latest volume represents 1) a work of lessons learned from prior editions, and in this way may be seen as an epistemologically iterative step in defining and characterizing the often ambiguous if not enigmatic qualities of "mental disorder(s)", or 2) merely an embellished version of previous volumes that perpetuates misnomers and vagaries and thus fails to be anything more than of nominal value.Whether endorsed as a reasonable gold-standard or criticized as limited in scope and utility, what cannot be ignored is the effect - if not power - that the DSM has exerted, and continues to exert, both within psychiatry and society at-large. Therefore, it is important to consider if, and how the DSM-V will manifest impact in and upon the character and conduct of psychiatry, medicine and the social sphere. Toward this end, we pose a Socratic question - from where have the DSM and psychiatry come, and to where are they going? Thus, this essay seeks to analytically scrutinize - and contextualize - the major developments that have occurred in various editions of the DSM, focusing upon factors that motivated its development in 1952, and the multiple changes and repercussions various editions have effected in psychiatry over the past sixty y