Talk:Diagnostic and Statistical Manual of Mental Disorders

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Former good article nominee Diagnostic and Statistical Manual of Mental Disorders was a Social sciences and society good articles nominee, but did not meet the good article criteria at the time. There are suggestions below for improving the article. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones
Date Process Result
January 18, 2013 Good article nominee Not listed
On this day... Facts from this article were featured on Wikipedia's Main Page in the "On this day..." column on December 15, 2010, and December 15, 2013.


DSM Copyright[edit]

Here is a collection of historical information relating to the DSM Copyright:

December 2005

March 2010

Old comments that lacked headers[edit]

It is a terrible shame to waste much energy whining about disclaimers. I would prefer a more critical approach consisting of the implications of using such a diagnostic i.e the overlap between disorders. Also links to relevent advocates and challegeners of the DSM would be ideal.

I made some changes, what do you think? I would like make more. What speically would people like? Some of the article appears to be POV, I tried to make it more objectiveExpo512 08:43, 6 March 2006 (UTC)

Isn't it like IVr or some upgrade of the original IV?

I think something needs to be said about the changes between III-R and IV, like the introduction of five different axes to differentiate mental, social and physical functioning. That whole system could be put in the introduction, since it's the current standard. -- Kimiko 19:03, 17 Mar 2004 (UTC)

I have added a link to a list of DSM Codes to the See Also section of this page. I'm new here, so I hope that I have remained within the proper codes of conduct or etiquette. Cool? Erikpatt 06:15, 11 Jan 2005 (UTC)

I have added some criticism of DSM IV, this may be a personal opinion but I think it's justified. See what you think.

Confusing, blathering article[edit]


  1. clear statement of what the DSM is
  2. some discussion (pref. in layman's terms) of how professionals use it
  3. section of criticism

Currently, a critique is buried in the "brief history" section. Here's some more criticism:

The use of the DSM, as Herb Kutchins and Stuart Kirk have said, reflects ‘a growing tendency in our society to medicalize problems that are not medical, to find pathology where there is only pathos, and to pretend to understand phenomena by merely giving them a label and a code number.’ [1]

Others have criticized DSM for permitting pressure groups to put in or take out things - instead of disorders being added strictly on the basis of scientific evidence. The exclusion of homosexuality was heralded by gay rights groups as proof that homosexuality is normal - yet it was only their political pressure on the APA that made it remove homosexuality. Uncle Ed 17:27, 9 November 2005 (UTC)

Added statement about how professional use it, by request aboveExpo512 (talk) 05:37, 30 November 2007 (UTC)

DSM-IV-TR Permissions Controversy[edit]

[This discussion might be interesting to anybody interested in,or knowledgable about, DSM-IV-TR: -- 19:13, 20 December 2005 (UTC)]

Link Update:

is the diagnostic and scinetific manual a science or pseudo science?


Wasn't the reason homosexuality was taken out of the DSM guide because of lobbying from gay rights activists? I ask because of the article's inference that homosexuality originally being in the DSM guide was a fault of the book. --Yodamace1 16:55, 5 January 2006 (UTC)

  • No, it was removed because it didn't fit the criteria of a mental illness. The idea that it was removed purely due to pressure from gay groups is a conservative myth.— Preceding unsigned comment added by (talkcontribs) 14 May 2013

The objectivity of the article is totally removed with the phrase "those homo fags". This should really be fixed, but I don't feel qualified to just change it to "homosexuals" or something else. --A Visitor 07:20, 8 January 2008 (UTC) —Preceding unsigned comment added by (talk)

The recent section about the Drs. Zucker, Blanchard and Lawrence being selected for the American Psychiatric Assoc.'s committees should have been corrected rather than entirely removed for reported reason that it is factually incorrect as to Lawrence. Whether Zucker and Blanchard promote so-called reparative therapy on children (they deny they do) it needs to be reported that an overwhelming majority of the Queer community (rightly or wrongly) is protesting their appointment largely on that basis. Oddly, the Queer community and NARTH are in agreement that Zucker and Blanchard are in favor of ex-gay reparative therapy for children (despite Z+B's claims not to be) partly because their actions contradict their words. —Preceding unsigned comment added by (talk) 20:06, 18 May 2008 (UTC)

I don't think homosexuality should have been taken out as a mental disorder. If there was enough public pressure to remove pedophilia as a mental disorder would that make it right. This is a fallacy of ad populum or in this case listening to a local minority. Politicizing a scientific manual is not good science. —Preceding unsigned comment added by (talk) 08:49, 25 November 2009 (UTC)

  • It was removed because it didn't fit the criteria for a mental illness. The idea that it was removed purely due to politics or pressure from gay lobbyists is a conservative myth. Also, pedophilia causes harm. Homosexuality does not (excluding an appeal to religion).— Preceding unsigned comment added by (talkcontribs) 14 May 2013

I wonder about the veracity of the following statement: "That 1974 decision [to declassify homosexuality as a disorder] is still challenged by some, mainly conservative and religious, groups..." The citation given doesn't back up that statement. In any case, it seems a little bit biased to me, as if the writer is simply trying to dismiss the objections. Aren't there any knowledgeable people who object to the reclassification who aren't conservative or religious? Is the opposite side labelled liberal or irreligious? Is there only a bias on one side? At what point is it discussed the homosexual groups were instrumental in removing homosexuality from the manual? Isn't the bias of homosexuals toward homosexuality something to be considered?-- (talk) 01:38, 6 July 2010 (UTC)

  • The idea that homosexuality was removed due to pressure from gay groups is a myth. It was removed because it didn't fit the criteria for a mental illness. You also ask "Aren't there any knowledgeable people who object to the reclassification who aren't conservative or religious?". No, there aren't. Attempts to reclassify homosexuality comes entirely from those two groups.— Preceding unsigned comment added by (talkcontribs) 14 May 2013

I have a minor issue with the final sentence of the first paragraph: "There have been five revisions since it was first published in 1952, gradually including more mental disorders, although some have been removed and are no longer considered to be mental disorders, most notably homosexuality." It doesn't seem to me that the phrase "most notably" is supported, partly because there is not really a standard way to quantify what is "most notable" (i.e., how is notableness measured? There are ways, perhaps, but it seems somewhat subjective which you might choose). This could be most simply solved by removing the word "most," but there may be better rephrasings. That homosexuality's removal from the DSM can be called notable at all (if not the most notable) strikes me as well supported in the Political Controversies section (section 4.6 of the article), so I think keeping the word "notably" is not a problem. Lukescp (talk) 07:22, 24 January 2012 (UTC)

Seems to me people should feel free to edit such things around in the article, given that as you say it's not a sourced or even specifically made point. Not sure actually if it should be in the first para, being as it is a point in the history. Eversync (talk) 22:53, 25 January 2012 (UTC)

Discrimination and future of DSM[edit]

Are you serious?! And to think that homosexuality itself was considered a "mental illness" until 1973. Such a move would show to the wider world that the DSM has no basis in objective scientific reality at all, but is just pseudoscience which slavishly follows social trends. I for one find it quite chilling that a person could be classified as mentally "ill" simply because of their political views or sexual tastes. You could envisage that sort of thing happening in the former Soviet Union, or in the "People's" Republic of China. 00:10, 15 October 2006 (UTC)

We must try to keep in mind that most of the concepts presented in the DSM can be viewed on a continuum and that almost all diagnoses require that there be significant impairment in work, social, or leisure activity that can be documented before the diagnosis is presented. Also, for most diagnosis there is a prevalence rate in which it can help us determine how rare the particular disorder should be within given samples. I do not have the research but if there was an addition of that calibar then it would be based on a rare impairing form of what is being referred to as 'bigotry'. Also, psychological testing uses the idea of clinical as opposed to statistical significance. Clinical significance can be usually seen in which those only scoring 2.5+ standard deviations are usually considered ill which is less than 10% of the population that it was standardized with. That is usually viewed rare enough to warrant further investigation. For this above example, the ideation of bigotry can be very over-simplified and become a belief in trend then what could conceivably be a detremental thought 'disorder' since I lack a better word at this moment. I will try to stress that clinicians use multiple resources besides just the DSM in order to make a diagnostic decision including lab and physician findings and psychological scores etc. UNache 23:26, 5 February 2007 (UTC)

No: Creating a specific diagnosis for extreme racism doesn't seem to be in contemplation.[2] The usual reasons for not including it are:
  • Other, existing categories are typically sufficient (paranoia, delusions, obsessions) and often much more descriptive of the whole situation. (It's likely that more mental health professionals need to recognize racism as a presenting symptom of these other conditions, but that doesn't make racism itself be the disease.)
  • Race is a culturally constructed identity, and racism can be a societal norm. Until the entire world (remember that this book gets used worldwide) is dramatically less racist than it is now, racism by itself can legitimately be considered a variation on culturally normative behavior. You can really only call racism a "disease" (a personality disorder?) if the client's society is normatively non-racist.
  • There don't seem to be any published cases of people who are pathologically racist (under the usual clinical standards: your ideations significantly interfere with your own everyday life) unless they also have other, significant mental disturbances. For example, I met a man last year whose severe paranoid schizophrenia prompted him to make an enormous number of anti-gay and anti-Jew remarks (averaging every fourth sentence, no matter the subject matter). However, in the context of the whole picture of his life, his racism was really a small symptom.
This is an issue that highlights the complexity of the DSM's broad subject matter. Some psychological problems are socially constructed instead of biologically determined. Some psychological "problems" are also perfectly normal (e.g., transient situational depression). The DSM covers all of the above. WhatamIdoing 03:57, 10 July 2007 (UTC)

Cautionary statement[edit]

Can anyone explain the purpose of the "cautionary statement" section? The first sentence sort of makes it sound like it is about a "DSM cautionary statement" that is part of the DSM, or is something related to it, but as I read the section it sounds more like the caution is being advised by an author of the article itself. If this is the case, something needs to be done -- no matter how well-intentioned a warning to the reader may be, it is not NPOV to say, "You should know that X is a bad idea" instead of providing facts. (It kind of runs afoul of the "avoid self-references" guideline as well.) This is why Wikipedia has a medical disclaimer. It would certainly be appropriate to have some text in the article describing how and why the DSM is not intended to be used by amateurs, but an entire section that positions itself as a caution from the article to the reader needs to be rewritten so that it only describes the subject from a neutral stance.

If anyone else understands whether the "DSM cautionary statement" is supposed to describe some external statement in the world, or whether it is meant to itself be a caution to the reader, please edit the article as needed. Thank you. –Sommers (Talk) 17:29, 24 January 2006 (UTC)

I've rewritten the section so that it only provides information, not advice, as described above. I think it's much more concise and neutral this way, and the section still gets it across quite clearly that the DSM isn't meant to be used by amateurs, so I don't anticipate any problems with the new draft. If anyone can replace the "Experts generally advise..." with a real citation, though, that would be great. If anyone has any objections to the changes I made, I'm more than willing to discuss them. Thanks. –Sommers (Talk) 01:57, 25 January 2006 (UTC)
The original version [3] was fairly neutral. It reminds me somewhat of the standard disclaimer before introductory abnormal psychology classes (The kind they claim they shouldn't be teaching because the information could be mis-used, but which they teach anyway). Probably more than a generic DSM disclaimer, there should be a statement that diagnoses should be left to experts.--Limegreen 21:28, 6 March 2006 (UTC)
I agree. However, I feel I should clarify: the point I was trying to make above (and below) is that the statement you mention should be one of fact and not of advice. Any competent encyclopedia article on the DSM should provide facts indicating that the diagnoses should be left to experts, without having to actually come out and state it to the reader. –Sommers (Talk) 04:22, 23 March 2006 (UTC)

Outdated links to cautionary statement[edit]

Upon further examination of which pages link to what used to be the dedicated "DSM cautionary statement" page, it appears that a lot of psychology-related articles were formerly referring to a page which contained a much larger and widespread description of problems perceived with the DSM. This is a problem, since most of those links now refer to a statement that has not properly existed since it was merged into this article. (A lot of it was moved into the "Development" section even before I did the most recent revision of what remained of the "cautionary statement" section.)

I think the best thing to do would be to remove (or at least rewrite) all direct references in other articles to the former cautionary statement. It was an explicitly POV (although well-intentioned) piece that, by its own title, existed only to make a statement about the weaknesses of the DSM (presumably to warn the reader against trusting it too much). It would be much better to describe these possible weaknesses, carefully in line with the NPOV policy, in a section of this article ("Criticisms" or something similar; it seems weird to have this under "Development" anyway) like we would with any controversial subject, and the other articles can point to the relevant issues with the DSM if and when they apply instead of to a blanket statement.

However, because the use of this "cautionary statement" page and the links to it predate my involvement, I'd like to get some feedback on all of this before I take it upon myself to start making changes across a lot of different articles. If no one objects, I'll get started on working my way down this list. Of course I shouldn't be the only one doing this: beside the fact that it's a big task, there are probably plenty of instances where an article says "(See the DSM cautionary statement)" where it really needs something more specific to be added, and I'll likely lack the necessary expertise in most of those cases. So if you want to make the edits yourself, please do. Otherwise, any feedback or information would be appreciated (including explanations about the former use of the cautionary page). Thanks.

Sommers (Talk) 05:00, 25 January 2006 (UTC)

(I've taken the liberty of moving several posts from here to the bottom of the page, so that they will be in chronological order. If Zeraeph or anyone else objects, please feel free to revert. Thanks. –Sommers (Talk) 22:13, 27 March 2006 (UTC) )


After having set this task aside for some time, I saw that there were no objections and proceeded. All mention of the former DSM cautionary statement has now been excised from the main namespace. The articles that formerly linked to the statement are no longer visible at the "What links here" link above, so in case anyone would like to review the changes, here is the list of the articles:

I hope this helps to improve the neutrality of Wikipedia's overall treatment of the DSM. Any remaining comments or questions about this matter are still, as always, welcome. Thanks again to Limegreen for the attention to my concerns. Happy editing! –Sommers (Talk) 04:10, 23 March 2006 (UTC)

While I agree that the cautionary statement presented a point of view and I understand the reasons for the merge (I merged them myself), I remain concerned that this particular point of view (a pov incorporated into and shared by the publishers of the DSM, the American Psychiatric Association) is rather significant. I perceive this particular information less as an opinion or editorial about the DSM and more like a "Mr. Yuk" for psychiatric diagnoses. I believe that sites such as this one, which draw individuals from outside of the mental health profession in search of clarification for diagnoses that they may have formally (or otherwise) received should have quick access to the pertinent and important information provided in a cuationary statement. So many of my clients are willing to blindly pursue treatment options that they believe are in accordance with a diagnosis that they may have arbitrarily received years and years ago. For this reason, I think a prominent sign saying "Stop and read this first!" that explains the limitations and purposes of diagnostic practices is important. I believe that it is the responsibility of the wiki community to acknowledge that the information available here is integrally linked with the treatment opportunities of those who access it. It seems that offering the reader easy access to a cautionary statement is part of this responsibility. I am a bit concerned that access to this information has been lost during the merge and revisions. There is a reason William Glasser refers to the DSM as "perhaps the most dangerous and harmful book ever created for mental health" and the cautionary statement is an industry accepted step toward recognizing the limitations and potential dangers of the DSM. It is naive to think that a layperson accessing basic encyclopedic information from this site will either acknowledge the limitations of this diagnostic toolbox or dig far enough as is currently necessary to access the warnings previously provided on the cautionary statement page. I was personally responsible for the merge as the community pointed out the limitations of the cautionary statement. However, I am concerned that the removal of this section from this entry removes the metaphoric Mr. Yuk and leaves readers less prepared to access objective information that may have significant impact on their lives. I hope that the wiki community can help with figuring out a way to prominently display this information in a wiki-appropriate format for readers. Erik 04:15, 22 March 2006 (UTC)

Thanks for your reply. First, I agree with everything you say about the DSM itself, and I'm glad you understand the POV problems with the original DSM cautionary statement. However, I believe what you are suggesting is also, for many of the same reasons, over the line with regard to NPOV. The central problem is that trying to caution the reader, even guide them toward or intentionally emphasize the relevant information with the metaphoric "Mr. Yuk" tag, is taking an instructional or persuasive stance; Wikipedia articles are allowed to do neither. Here are the details, as I see them. (Please forgive a very long post. This is a complicated matter and I wanted to make sure I didn't miss anything. Also, the suggestions you make are good ones, and the reasons that, in my opinion, we can't follow them are subtle but important.)
Wikipedia articles are supposed to be written so as to only provide information, from a neutral standpoint, with no authorial voice or stance. Trying to say "Stop and read this first!" is communicating something from author to reader, which is unacceptable. As I've said, the DSM article should carefully explain the book's limitations and describe the warnings experts have given against its improper use. However, it (and other pages) must not say to the reader "Hey, make sure you read this stuff about experts' warnings before you misuse the information". To do so would be unencylopedically POV, because—even if it isn't opinionated or editorial in tone—it's advancing the opinion that people need to be aware of a certain thing lest they make a harmful mistake. Much discussion has already taken place about giving special warnings to readers, and the decision has been not to do so (even without POV problems like this): as I said to Zeraeph above, please refer to Wikipedia:No disclaimer templates.
Also, I appreciate that the DSM cautionary statement page itself, as it currently exists, does neutrally provide facts much in the way I'm recommending, but it still needs to be removed. By taking these facts about the DSM's limitations and corralling them into a separate page (or even a separate section in the regular DSM article) in such a way as to warn the reader, we're creating a textbook example of a POV fork, which is a very bad thing, more so because the information has been explicitly put there to make a "statement". As I've said, the information itself given in the cautionary statement can and should be present in the regular DSM article, but must not be arranged in a cautionary or persuasive manner.
As for your concerns about laypersons not digging deep enough to see that information, I agree that this is probably a real problem, but I think it's a symptom of the article not presenting those facts properly. Because the point of view is, as you say, so widespread, the facts in question could be presented quite prominently in line with the NPOV policy without actually highlighting them to the reader with special links or tags. It's my opinion that, if the article were improved to a sufficiently readable and balanced condition, any rational and fairly intelligent person who reads the article would walk away with an understanding of how the DSM should and shouldn't be taken. (By analogy, someone who reads the article on firearms and had never heard of a gun before will walk away with the understanding that a gun could kill them, without a cautionary statement coming out and explicitly guiding them toward the gun safety article.) The other articles that link to the cautionary statement should take a similar approach, treating the DSM as one source of opinion without implying it's an incontrovertible reference book; I think they already do a fairly good job of this and they can be further improved if necessary. If the problem with the main DSM article is serious enough, perhaps it could be listed for review. Finally, because of the policies that the cautionary statement violates as I describe above, I think it behooves us to remove it right away, rather than leave it as a stopgap measure until the other articles receive such improvements.
Thanks for discussing this matter and for the understanding you've already displayed. (Thanks also for putting up with my long-windedness.) Any replies or questions would be very welcome. Unless there is a good reason not to, I'd like to get the cautionary statement and the links to it removed as soon as possible. Thanks again, and happy editing!
Sommers (Talk) 17:08, 25 March 2006 (UTC)

For now, I have restored the last, brief, basic version of a "Cautionary Statement" that existed on this article as DSM cautionary statement. This seems to be some kind of legal requirement and, as a whole we are skating on such thin ice we are swimming, already with DSM and the APA, doesn't do to poke THAT particular tiger with too many sticks. I'm restoring the links as fast as I can. My only POV on this is FEAR OF THE APA ;o) --Zeraeph 13:17, 23 March 2006 (UTC)

Would you care to elaborate? I can see an argument for it being an ethical requirement, but under which countries laws is it a legal requirement? Also, wouldn't it be more appropriate to have a one sentence spoiler on each page. Perhaps if there is some consensus, a template could be created, similar to the plot spoiler warning{{spoiler}}:
--Limegreen 23:07, 23 March 2006 (UTC)
There is no such legal requirement, and (while we should be as responsible as possible) the APA has no power to do anything to Wikipedia, unless they wanted to bring a groundless lawsuit. It is more or less the stated position of Wikipedia that its normal disclaimers (including the medical disclaimer, which applies here) are sufficient to be responsible to the readers and to protect Wikipedia from any liability, and it has already been decided at Wikipedia:No disclaimer templates that there is no need for additional warning messages like the DSM cautionary statement and what Limegreen suggests. If you think that the little "disclaimer" link at the bottom of every page isn't sufficient to warn readers, you probably aren't alone, but the thing to do is bring it up at the Village Pump, not create new protective measures on the fly. Thank you, however, for your concern and boldness regarding this matter.
Unless a consensus decision dictates otherwise, I believe that, under existing guidelines, your edits will need to be reverted soon. Please also see my remarks below (in response to Erik's post) about the unacceptability of the DSM cautionary statement in its current form. Any additional questions and discussion are most welcome. –Sommers (Talk) 17:08, 25 March 2006 (UTC)

The DSM contains it's own cautionary statement see [4]. HOWEVER the APA specifically refuses permission to use ANY content from the DSM IV TR including criteria. Strictly speaking all criteria should exist only as links to sites for which permission has been given.

All DSM criteria and transcriptions of same should be deleted. Now I am certainly not going to DO that deleting, but that is their position. When articles link to criteria on behavenet, the criteria already contain links the warning statement, as they are required to do. It's all a very dodgey area, but where the criteria still appear as part of an article it is simply wise to link the cautionary statement as would be required by the APA to avoid stirring them up. It would probably be best to just link their own disclaimer on behavenet.

And, I am afraid, if they take a mind to it, the APA most certainly CAN sue the bejaysus out of Wikipedia for copyright violation at any time, not least because permission fort use of criteria has been sought and refused...what on earth makes you think they can't? --Zeraeph 17:28, 25 March 2006 (UTC)

Wikipedia has the right to quote the DSM in line with our fair-use rights under copyright law. Sommers (Talk) 15:31, 27 March 2006 (UTC)
No it doesn't. "Fair use" isn't a right, it's a complex legal principle that must be proven through the courts to stand if someone wants to contest it. The APA contest that principle regarding wikipedia in specific (if you don't believe me, mail them for permission "Chad Thompson" <> and explain about "fair use") and they have the lawyers and funding to back it up literally any time they feel like it, the trick is, trying to avoid them "feeling like it". This particular "storm in a teacup" is JUST the kind of thing to set them off at last.
Just for the record, while I personally feel the APA should concede "fair use" and that it would be to the advantage of all that they do so, sadly they do not agree. However, I cannot think of any counter argument to one of the arguments they put forward, which is that they cannot allow "fair use" for criteria where the text can be altered at any time. --Zeraeph 14:18, 28 March 2006 (UTC)

Reprinting entire sections of the DSM (or perhaps even individual criteria, word-for-word) would of course be copyright infringement, but if an article discusses a particular disorder and we want to give the fact, "The DSM lists X as a diagnostic criterion for this disorder", I don't believe the APA can legally prohibit us from doing so (because facts aren't copyrightable). Now, when Wikipedia articles do go beyond this point and infringe on the DSM, we should treat it like any other copyvio problem. (I agree that the problem does indeed exist for some articles.) But as you seem to be aware, there are two problems with using the cautionary statement to address the copyright matter: (1) Wikipedia hasn't been given the same permission as, for example, BehaveNet, so linking to a cautionary statement is a requirement that doesn't apply to us; and (2) as I've pointed out, Wikipedia's DSM cautionary statement is not the same thing as the DSM's own, so there is no point in linking to it anyway, except for a blind guess that it will somehow appease the APA.

If the purpose of the DSM cautionary statement is what you tell me, then what we're doing is bending the NPOV policy to meet an arbitrarily made-up standard in order to mimic a condition of a permission that we haven't been given. There's no legitimate reason to violate the NPOV policy and this isn't even a particularly good one. The cautionary statement is a POV fork, the links to it imply a critical opinion of the DSM, and they need to go now. That said, I understand your opinion and I'm glad you're paying attention to these matters. Thanks again for continuing to discuss this civilly. I look forward to your response. –Sommers (Talk) 15:31, 27 March 2006 (UTC)

I think you are getting a bit too far away from the point here, which is the PURPOSE of the DSM cautionary statement, which is, simply to explain what the DSM IS intended to be and what it is NOT, on behalf of the APA, to avoid misunderstanding or misuse. Like an "inflammable" or "dry clean only" label on a garment.
There are three ways to achieve that:
  • A Template
  • A link to a paraphrased article
  • A link to verbatum reproduction such as on behavenet
I would also very much like to see you qualify your statement that the existing article is POV by showing exactly which words and phrases you believe to be POV and why, because I honestly believe "POV" is a total misnomer for the point you are trying to make.
I am not saying that you shouldn't make your point, but if it is worth making at all it is worth making accurately.--Zeraeph 14:27, 28 March 2006 (UTC)
Please pardon the delay in my responding. As you know, I've addressed the "POV" thing at Talk:DSM cautionary statement. As for the top paragraph of your last post, I can respond to that with two of the points I've been trying to make all along. I apologize if these points weren't previously made too concisely or clearly, since this is (as I've said) a complicated matter and I can see how they may have gotten lost in the details. So, regarding the purpose of the statement:
  • The title of the DSM cautionary statement makes it brazenly clear that it is, in fact, a statement. Any such statement from the article to the reader can't be NPOV, because, no matter how impartial the statement itself may be, it reflects the point of view of the person or people who think readers ought to hear the statement. The central point here—which I think you also may be getting away from—is that it's just plain unencyclopedic to try to make a statement of any kind (let alone one with a cautionary purpose) in the main namespace, where we're only supposed to be providing information.
    • Sub-point: You say yourself that the cautionary statement is meant to be "on behalf of the APA". But "on behalf of the APA" is a point of view.
    • Also, to avoid misunderstanding, I do agree that we must "explain what the DSM IS intended to be and what it is NOT [...] to avoid misunderstanding or misuse", but we are bound by NPOV to do it in the article. Collecting facts from the article into a special statement off to the side is unencyclopedic.
  • The links that currently follow every citation of the DSM, which read "(See the DSM cautionary statement)", carry an implication something like: "The DSM says this, but you can't always take it at face value." If this were strictly a fact, then the links would indeed be as simple as a "dry clean only" label or the metaphoric "Mr. Yuk" advocated above. Unfortunately, it's not a fact; it's an opinion—an exceedingly widely-held and well-supported professional assessment, but an opinion nonetheless. The NPOV policy prohibits us from echoing that opinion, and taking special measures to urge readers to "see the DSM cautionary statement" comes far too close to doing exactly that.
I hope that does make my position a bit clearer. Thanks for your continued interest in hearing my points. –Sommers (Talk) 15:54, 30 March 2006 (UTC)

NPOV and vague words[edit]

Impotence, premature ejaculation, jet lag, caffeine addiction, and bruxism are examples of surprising inclusions

Who finds them surprising?

and are but only several that non-psychiatrists might not consider to be mental illnesses "non-psychiatrists"? And what do psychiatrists (and psychologists, butchers, bartenders...) consider? Apokrif 16:48, 2 April 2006 (UTC)

Only a group of psychiatrists (and psychologists, too if they'd be invited), apparently drunk on their own power, would hold a vote (and a majority vote of those in the inner sanctum is exactly how entries are made) that would deem the above to be "mental diseases." That is, after all what we are talking about here. It is a valid criticism and more than a few psychiatrists note that the DSM now includes damned near anything that anyone might possibly complain about.Homebuilding 03:05, 12 September 2006 (UTC)

I totally agree, a good amount of criticism of the percieved "medical authority" of DSM-IV is right on it's place on this page. Let's face it, the overwhelming majority of "diagnoses" in the DSM are nothing else but a collection of subjective POV's of a bunch of wealthy and influential psychiatrists, who define behaviors outside the scope of currently socially acceptable limits as "diseases" (a.k.a. "we don't like it, so it must be a disease"). It has about as much objective validity as The Dianetics or the infamous Malleus Maleficarum. The insiders are very much aware of these facts; a considerable amount of psychiatrists, with several decades of practice, have been outspoken against the practical limitations of DSM and it's validity. F. inst. the prominent and influential psychiatrist Loren Mosher stated in his resignation letter to APA that "Finally, why must the APA pretend to know more than it does? DSM IV is the fabrication upon which psychiatry seeks acceptance by medicine in general.", whilst the former APA president Robert Spitzer echoed him in an interivew, admitting "The DSM is not a scientific document.. very few of the categories have an empirical base". Unless the DSM openly states that it's labelings are unscientific/philosophical/religious and to be taken as purely subjective guidelines/alternatives in response to "troubles of daily life", it deserves to be publicly and ruthlessly exposed to the scrutiny of professional criticism. 17:29, 3 October 2006 (UTC)

Please note that Robert Spitzer, quoted just above, was and has been the driving force of the DSM--and has "founding father" status. He appointed the entirety of the initial committess and boards of the DSM. He has been the final editor of all DSM versions, up to and including the DSM IV. Once it's off his desk it is ready for the vote, up or down. He has tremendous power over how health insurance money is spent on "mental health" services as this book defines what mental health is. 02:17, 12 October 2006 (UTC)

I would like to repeat that there is much more to it then finding a behavior a disease etc. as I have stated within the discrimination section of this talk article. I would like to add that there are many philosophical POVs in various forms that gave birth to the different ideas of what causes mental distress. Also, as I have said before very few disorders do NOT have the tag that it must give the individual trouble in either social, work, or liesure activity. Saying that, caffeinism is the physiological addiction as well as the psychological addiction in which the individual has withdrawal symptoms such as headaches etc that interfere with their normal functioning in which they need to consume more caffeine based products to allieviate and even act normally. Jet lag is defined as repeatedly moving from time zone to time zone in such a way which renders an insomniatic state that interferes with the individuals social, occupation, or leisure activities. Also, the comment about naming everything a disease is not truly the case. A disease has a specific definition as taken from for this debate "a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment." There have been links to genetic contributors for many mental disorders including schizophrenia, alcohol abuse, opiate abuse, one particular form of insomnia etc. Though there are what are called disorders as well in which there may be a cognitive impairment that leads to an individual suffering social, occupational, or leisure activities. Finally, there are even psychologists and psychiatrists that reject the medical model and use a phenomenological approach to helping individuals with problems that are not biologically based. —Preceding unsigned comment added by UNache (talkcontribs)

Who wrote the above paragraph? EverSince 10:18, 24 January 2007 (UTC)
That would be me. Sry I haven't been around lately to show my 2-cents. UNache 5:19, 5 Feburary 2007

DSM, CBT and psychopharmacology[edit]

What about the claims that DSM was designed to (or is used to) promote cognitive behavior therapy (rather than, for instance, psychoanalysis) and the use of psychoactive drugs (e.g. methylphenidate)? Apokrif 16:54, 2 April 2006 (UTC)


It's worth noting, as an illustration of just how potentially subjective and socially constructed the various diagnoses in the DSM-IV are, that Homosexuality was listed as a disorder until 1973.

It's also VERY MUCH worth noting that the authors have been shown to have links to the Pharmaceutical Industry: — Preceding unsigned comment added by (talk) 23:41, 11 June 2006

Just a few thoughts:
  1. You can't judge the objectivity of the DSM based on the example of homosexuality being listed as a disorder over 30 years ago. The field of psychology/psychiatry is a relatively young field, and in the past it was much more attached to negative social and cultural forces than it is now, as it was more dominated by "old world" doctors. It's a different situation now.
  2. Nothing can be taken from that Washington Post article. LOTS of doctors act as consultants for pharmaceutical companies. That on its own means absolutely nothing for their objectivity. If the study bringing this out is included in the article (which it was until somebody blanked it), no inference of influence can be stated.
  3. That being said, there needs to be a good section comparing the positives and negatives of the DSM-IV, but in an NPOV way.
-- Tim D 17:01, 18 November 2006 (UTC)

Will someone please provide a page on Wikipedia detailing the destructiveness of this DSM document, and the many lives it has destroyed? there are websites devoted to anti-psychiatry you might want to link to. I beg of someone! please help people who have been destroyed by this process of labelling and those in the future who will be. This document is nothing more than a political and cultural means of control. It dehumanizes the wide range of human behavior. For the love of God I wish the DSM would be discredited as the voodoo it is. Psychiatry is a huge business and most lost souls primarily need to be held and loved because of horrible things that have happened, instead are villified and ridiculed and marginalized. If anyone wants to contact me they can, at Its not that I'm against the people who perform these jobs (I think most approach the profession with a certain desire to help), but the whole method of treating people with problems has to change. A new paradigm! 01:40, 2 January 2007 (UTC)

Why can't we just say that homosexuality might be a mental disorder, like many other things in the manual? If it was right "thirty years ago" then we haven't made any progress at all in understanding the mind if we ignore evidence because it makes us uncomfortable. I do not imagine that many people are comfortable thinking that they have a mental disorder, but hey, plenty do. It is worth noting that other explanations for homosexuality may be even less palatable. 08:50, 31 March 2007 (UTC)
For the user seeking "A new paradigm!": The page you want is called anti-psychiatry. WhatamIdoing 03:03, 10 July 2007 (UTC)

Re. merging brief 'axis ii' into DSM:Multiaxial...[edit]

I would prefer not to merge, but to keep that article as a very brief one focused on that subject (like the other axis n articles). "Axis n" are mentioned frequently in other articles, usually without explanation (except of course in the main DSM article). A person who clicks on those references more likely wants a quick explanation, rather than finding themselves in the midst of the large and complex DSM article (if they're that interested in the DSM as a whole, they probably know what the axes are already; and if they become interested in dsm via the axes, it's only one click further). Just my $0.02. —The preceding unsigned comment was added by Sderose (talkcontribs) 12:56, 8 January 2007 (UTC).

Delete Citation Needed lines[edit]

I would suggest that if references and citations cannot be provided for the lines marked, then those statements are POV and also do not meet the Wikipedia standard of being verifiable and should be deleted. DPetersontalk 14:38, 14 January 2007 (UTC)

Removal of article unreferenced tag[edit]

I removed the "unreferenced" tag at the top of the article because User:EverSince has done a wonderful job of adding sources and citations. DPetersontalk 20:01, 28 February 2007 (UTC)
I was thinking of removing the tag also, thanks. I'm also thinking of removing the unverified tag from the history section, as generally covered by the sources I think, e.g. the number of pages/disorders in each version is tabulated in the Mayes, R. & Horwitz, AV. (2005) article. EverSince 09:47, 1 March 2007 (UTC)
Yes, that tag should also be removed. regards. DPetersontalk 00:21, 2 March 2007 (UTC)

DSM-IV Sourcebooks[edit]

The DSM-IV doesn't specifically cite its sources, but there are several "sourcebooks" intended to be APA's documentation of the guideline development process, including literature reviews, data analyses and field trials. Funnily enough these key source materials for the major psychiatric "bible" of our time seem to be rarely referred to, or stocked even in major libraries, let alone read. I thought I'd post a mixture of available sources about them here before just trying to edit, since there's so much detail and perspective that somehow needs to be summarised in a balanced way.

Widiger TA, Frances AJ, Pincus Haet al. DSM-IV sourcebook. Vols 1–4. Washington, DC: American Psychiatric Association, 1997.

Volume 1 Volume 2 Volume 3 Volume 4 (possibly not even in print any longer)

The DSM-IV Classification and Psychopharmacology by authors including the guy who directed the process[5]

A Participant's Observations: Preparing DSM-IV

Critical reviews of vol 1 (appears twice) and Vol 2 by mental health professional author on reputable site.

Other articles covering the sourcebooks and DSM development:

Whither psychiatric diagnosis

PSYCHOPATHOLOGY: Description and Classification

Diagnosis and Classification of Psychopathology: Challenges to the Current System and Future Directions

EverSince 13:48, 24 January 2007 (UTC)

Criticism section is really a controversy section and should be pruned[edit]

The criticism section generally brings up controversial viewpoints which are neither the majority viewpoint or the minority viewpoint. The whole section needs to be pruned. --scuro 02:35, 4 April 2007 (UTC)

What would you suggest? Maybe you could paste the section here with your suggested changes?DPetersontalk 12:25, 4 April 2007 (UTC)
This is something I have been learning about off-Wiki very recently, and I feel that we DO need to admit of the wide variety of (it seems to me) VERY valid criticism of the DSM. However it might best best to try and limit that to criticism that can be sourced in terms of WP:RS without any speculation at all? --Zeraeph 13:12, 4 April 2007 (UTC)
Don't get me wrong...antipsych critics and the CCHR have done some good in the past, especially when the mental health field was at it's early and sometimes barbaric stages.
Still the Wikipedia DSM article is not about value judgements about critics or their ideas. If they have a valid criticism that can be sourced, it belongs in the main article. Problem is, that much of what they believe can not be sourced to majority or minority sources. These ideas are simply part of a larger belief system based on a core set of values and not based on a body of evidence. They have a habit of making the "facts" fit the idea. ie Ritalin is speed.
--scuro 16:33, 4 April 2007 (UTC)
Below is a possible edit that took me a minute or two to do. Others could improve upon it. Even that edit could be pruned. This section should instead have links to other articles like Antipsychiatry or perhaps a seperate article entiled. "criticism of the DSM". Some of the deleted section was unsourced, some biased, some of it could be put into a history section....anyways the point is that the criticism section needs to not detract from the main article.
The DSM was criticised soon after it's inception. Deconstructive critics assert that DSM invents illnesses and behaviors. Detractors of DSM argue that patients frequently fail to fit into any particular category or fall into several, that time limits and numbers of clinical characteristics required for a categorization are arbitrary and that attention directed towards finding a suitable DSM category for a patient would be better spent discussing possible life-history events that precipitated a mental disturbance or monitoring treatment. The DSM has also been criticized for allegedly classifying behaviors that are simply uncommon in the society of that time such as homosexuality.
--scuro 16:48, 4 April 2007 (UTC)

I don't think that addresses the issues sufficiently. Here's my first cut at a version that includes more detail but tries to stay on topic:

--Criticism-- The DSM was criticised soon after its inception. Detractors of the DSM commonly argue:

  • that patients frequently do not fit neatly into any particular category, or that they fall into several;
  • that time limits and numbers of clinical characteristics required for a categorization are arbitrary; and
  • that resources directed towards finding a suitable DSM category for a patient would be better spent discussing possible life-history events that precipitated a mental disturbance or monitoring treatment.

A Columbia University team headed by Robert Spitzer, an editor of the DSM, acknowledges a concern about the DSM in their annual report of 2001: “Problems with the current DSM-IV categorical (present vs. absent) approach to the classification of personality disorders have long been recognized by clinicians and researchers.” Among the problems, they list “arbitrary distinction between normal personality, personality traits and personality disorder” and point out the fact that the most commonly diagnosed personality disorder is 301.9, Personality Disorder not Otherwise Specified. [1]

Deconstructive critics assert that DSM actually invents illnesses and behaviors through the ostensible process of describing them.

The DSM has also been criticized for wrongly pathologizing behaviors that are simply uncommon or not approved in the society of that time such as homosexuality, which was described as a mental illness until 1974.[2] Based on this successful political action, some people diagnosed with gender identity disorder, various forms of paraphilia, and other "diverse states of being" hope to have these labels removed from future manuals as well.[3]

The potential for conflict of interest has also been raised. Roughly 50% of the authors who previously defined psychiatric disorders have had or have financial relationships with drug companies.[4] This criticism is normally leveled by people who oppose the use of pharmaceutical drugs to treat mental illness.

I thought that the "Eew! We're not like those people" remarks by members of one paraphilic group against members of another paraphilic group detracted from the overall point, which has nothing to do with the wide range of paraphilic behaviors or their potential for social acceptance.

The bit about half the authors having been paid to work for a drug company at some point irritates me, mostly because no one is pointing out that 100% of the editors have a "financial relationship" with an institution (the APA itself) that promotes very expensive talk therapy treatments as its bread and butter, even though talk therapy in isolation may be completely useless for some conditions. The activist charge here may be true enough, but the focus on (inherently tainted?) pharmaceutical money seems selective in a very slimy way.

What do you think? Do we have a consensus to include the details but lose the remarks? WhatamIdoing 05:01, 10 July 2007 (UTC)

It seems to me that we should add a section discussing the benefits of the DSM. (neutral point-of-view)I think this could be done in a different section. ~

(NOTE: I did not contribute the immediately previous unsigned, undated comment.) Do these criticisms also apply to the relevant similar sections of ICD-9/10/11? If so, should that be noted here? Perhaps a whole new article needs to be created, discussing the relative pros and cons of these sorts of categorical diagnosis methodologies (NPOV) and simply referenced here and on the ICD pages? I am not qualified to create such a discussion, should that be the case.Spartan26 (talk) 16:00, 2 April 2010 (UTC)


  1. ^ Spitzer, Robert L, M.D., Williams, Janet B.W, D.S.W., First, Michael B, M.D., Gibbon, Miriam, M.S.W., Biometric Research
  2. ^ "The diagnostic status of homosexuality in DSM-III: a reformulation of the issues", by R.L. Spitzer, Am J Psychiatry 1981; 138:210-215
  3. ^ "GID Reform Advocates"
  4. ^ Cosgrove, Lisa, Krimsky, Sheldon,Vijayaraghavan, Manisha, Schneider, Lisa,Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry

Why the comment in the History section on the removal of Homosexuality from DSM?[edit]

It seems bizarre that this is here. Homosexuality is just one of many conditions. Why is it mentioned specifically here? Its inclusion looks agenda driven. I move to remove it.LCP 21:16, 24 May 2007 (UTC)

I support that DPetersontalk 21:44, 24 May 2007 (UTC)

It belongs there, in detail, just like "bleeding" is part of the history of medical treatments. Truly it is no longer central to the practice of medicine and there is documenation of progress with Joseph Lister through germ infestation theory. The point is that psychiatry continues to make their decisions regarding inclusion by plebesite (just as they have done since the initial conception of te DSM. Yes, that was in 1973--and the key players, such as Robert Spitzer, are still at the helm. It remains at the core of how the APA conducts the fundamental and essential task of defining mental illness.Homebuilding (talk) 22:46, 19 March 2010 (UTC)

It would be amusing, if it were not so sad, that leadership on psychiatry appears to promote tolerance, while every revision of the DSM defines and describes ever more aspects of the human condition as deviant and worthy of a diagnostic name and number. And surely, in every case, somewhere, someplace someone will dream up some therapy that they can bill for. In all of these situations, questionable definitions are followed by "treatments" of ever more dubious value. —Preceding unsigned comment added by Homebuilding (talkcontribs) 22:42, 6 February 2010 (UTC)

DSM and Politics section[edit]

I addded the information that I removed from the History section. I am not sure if I have put this new section in the best place, but I think the information is important as it demonstrates how the community interpretation of a "condition" can effect how the mental health community thinks about a condition.LCP 22:15, 24 May 2007 (UTC)

Thank you for continuing to include that information; I think that it is important as well. I happened upon this page while looking for information on the removal of homosexuality from the DSM for a school project I'm working on... Just thought I'd let you know that "This American Life" (which is on NPR) recently had a show on this. I just listened to the podcast, and found it interesting, so I thought that the information might be of use here. You can find the website for that show with a quick search, and then listen to the episode from the website, if you want. The title of that episode is "81 Words". I would edit the page myself, but I don't wish to step on anyone's toes, I haven't done much editing around here in the past, and I ought to get back to writing my assignment! Anyways, I hope you find that useful, or at least interesting. Ciao! --ChatOmbre 02:45, 31 May 2007 (UTC)
Please feel free to step in. Wikipedia is a community project, and fiefdoms are contrary to the Wikipedia ethos. If you are uncomfortable publishing live, post a sample of what you want to include here, and others will comment on it.LCP 15:21, 31 May 2007 (UTC)

DSM-IV Codes[edit]

You know, I've been watching this page for a few weeks, and what I can only describe as its slow-motion revert war is getting on my nerves. Some people clearly think that it's appropriate for the DSM page to link to the DSM-IV Codes page. Some people clearly disagree. Not one of these people has bothered to do get a discussion going on the subject. Although I'm generally inclusionist, I don't really care one way or another. But I'd really appreciate it if you'd type a little note here before you make that change again, okay? Something approaching a consensus would be nice. WhatamIdoing 15:32, 23 July 2007 (UTC)

Description of the DSM-V Task Force members[edit]

"The APA has entrusted the revision of the DSM to world-renowned scientists who have vast experience in research, clinical care, biology, genetics, statistics, epidemiology, public health and consumer advocacy. They have interests ranging from cross-cultural medicine and genetics to geriatric issues, ethics and addiction. As a group, task force members have authored over 2,500 research reports, books, chapters, white papers and journal articles." This (particularly the first and third sentences) clearly consists of a positive evaluation of the membership of the task force, and not a neutral description of its composition. What is the informational value of the word "vast" here? Is there any reason for an encyclopedia to mention the number of articles published by members of this task force? Presumably someone with an interest in the DSM edited this in.—The preceding unsigned comment was added by (talk) This clearly consists of a positive evaluation of the membership of the task force, and not a description of its composition. Presumably someone with an interest in the DSM edited this in?

Edit the entry as you see fit; due to lack of telepathy, I wasn't sure why you added the tag (I don't think you need it though, be bold and make the necessary changes; although I'm wandering... maybe they are world-renowned scientists — I have no opinion either way). Thx. El_C 22:41, 21 August 2007 (UTC)

More disease names doesn't mean more sick people[edit]

I've pulled this change:

  • Each subsequent revision of the DSM contains additional entries. It is difficult to justify the claim that there are ever-increasing numbers persons defined as mentally ill during a time when the numbers of "therapists" has exploded and the numbers and types of medications used has comensurately increased.

primarily because it's unsourced, but also because it contains a logical error. The number of newly described subtypes of mental illness doesn't say anything about the number of people who have mental illnesses. This is like saying that the world produces a billion pounds of apples each year, and if you replace the "red apples" category with the names of twenty specific kinds of red apples, that somehow the world suddenly produces twenty billion pounds of apples.

This mental error has come up before on this page. The DSM describes kinds of mental illnesses (and a few not-really-illnesses). It does not make anyone be sick or change the number of people who are sick. WhatamIdoing 21:39, 13 October 2007 (UTC)

Referencing the DSM in APA Format[edit]

Why do we have this section on "Referencing the DSM in APA Format"? Is this normal for book pages? If you look up Catch-22 or Green Eggs and Ham, is there a section on how to cite it in a bibliograph? I understand that it might be useful, but is it encyclopedic? WhatamIdoing 23:01, 18 October 2007 (UTC)

This section, I agree, is silly. I moved it to the bottom for now. I would be happy to just delete it. Perhaps it is the APA (that is american psychiatric assoc..) 'party line' on how they want their book referred to. Maybe not. However, it probably should be up to the author to choose.Expo512 (talk) 05:42, 30 November 2007 (UTC)

The "APA Format" refers to the "APA style," from the Publication Manual of the American Psychological Association, not the American Psychiatric Association. This style guide is used by a wide range of scientific publications. There are other schemes, e.g. that of the MLA (Modern Languages Association), used in other academic fields. As students are increasingly using Wikipedia as a source for essays and academic presentations, it would be a kindness to provide them with references in the form appropriate to their subject. NRPanikker (talk) 02:41, 5 February 2008 (UTC)

I understand that it might be useful, but is it encyclopedic? WhatamIdoing (talk) 17:43, 5 February 2008 (UTC)
More importantly, it's not even there now, as Athing removed it on 30/11/07 for being "unencyclopedic." It was not accurate to include the claim that DSM IV is the standard reference text for psychiatric diagnosis, since that description applies better to ICD 10. NRPanikker (talk) 16:55, 8 February 2008 (UTC)

Wartime origin of the DSM[edit]

The main article does not make it clear that the postwar DSM grew out of a clash between psychiatric practice and the requirements of the armed forces and Veterans Administration during the second world war. Previously the American Medico-Psychological Association (later the American Psychiatric association) had produced, in conjunction with other bodies, a Statistical Manual which attempted to replace the diagnostic schemes used in the different state hospital systems and academic centres. This went through at least eight editions. However, it was common for a psychiatric consultation, especially with an office patient, not to lead to any clear and explicit diagnosis. Often the standard diagnoses, when applied to abnormal behaviour appearing in the extra-ordinary circumstances of the war, appeared to be wrong, in that the course of symptoms and the long-term outlook was not as expected. Many conditions that would not receive medical intervention in civilian life had to be labelled and managed, whether as diseases, crimes or breaches of discipline. The military and its hospitals found it necessary to label and tabulate many such encounters, and a couple of schemes were developed in the course of the war which returning medical officers found to be of use in civilian practice also. The introduction to the first edition of the DSM gives a brief account of that situation. The DSM-I was devised to reconcile these schemes in the days before the insurance companies acquired hegemony over American medical practice. NRPanikker (talk) 16:36, 2 January 2008 (UTC)

Is this WP:V? Can you provide reliable sources to back up this explanation? WhatamIdoing (talk) 19:11, 2 January 2008 (UTC)
My reference for the above is the first edition of the DSM, which was reprinted by the APA to mark its 50th anniversary a few years ago (2002?). I don't have it at hand right now, but will get hold of the bibliographical details soon. Presumably all this would have been discussed in the (APA's) American Journal of Psychiatry at the time, but scientific and medical libraries nowadays throw everything out after ten years, so the details may not be easy to find. NRPanikker (talk) 17:01, 3 January 2008 (UTC)
The full reference: The Committee on Nomenclature and Statistics of the American Psychiatric Association, Mental Disorders, Diagnostic and Statistical Manual Washington: American Psychiatric Association 1952 - reprinted for the APA Sesquicentennial, May 1994. NRPanikker (talk) 03:53, 4 January 2008 (UTC)

Globalization tag[edit]

I have removed the globalization tag because it is unexplained. I had a conversation a while ago with the editor who added the tag; as I recall, the editor seemed to think that:

  • the article needed to further emphasize the fact that the DSM is not the only such book/system in the entire world, so that readers would not confuse the fact that it is very widely used with the reality that other options exist;
  • the article, which is about an American book, should include more references which have absolutely no American connection (e.g., it's not good enough to be a Spanish researcher if you publish in an American journal); and
  • the sloppy statement about DSM-based diagnosis being required should be labeled as being specifically American (and IMO the editor is absolutely right on this point).

If you think that a globalization tag will result in the improvement of this article, then please restore it and explain your concerns, in detail, right here on this talk page. This will help other editors figure out how to address your concerns. Thanks, WhatamIdoing (talk) 20:47, 4 March 2008 (UTC)

Mental retardation on the axis system[edit]

Beginning with the 1987 Diagnostic and Statistical Manual (DSM-III-R), mental retardation is classified as an Axis II disorder. See [6][7][8] and about a half a million other webpages. Interestingly, this change was apparently (ultimately) the result of a lawsuit, City of Cleburne v. Cleburne Living Center.[9] WhatamIdoing (talk) 19:10, 2 April 2008 (UTC)

Some &Clarify[edit] later —Preceding unsigned comment added by Ben Meijer (talkcontribs) 22:33, 18 May 2008 (UTC)

On-line petitions as WP:RS[edit]

WP policy requires that the person putting the text on the page carries the burden of proof that the claim is verifiable by a reliable source. On-line petitions do not meet that standard. I can recommend only that you employ some of the available venues, such as the RS noticeboard, to ascertain whether your source has a reputation for accuracy and fact-checking. Until then, reverting this page to reinstate text that has no RS behind it violates WP:V. I am amenable to this discussion being moved to our mediation discussion.
MarionTheLibrarian (talk) 23:50, 13 June 2008 (UTC)

Sometimes the person putting the text doesn't do a good job of sourcing, that's true. Any editor can help; since it's easy to find sources for this, why not just add them, instead of remove stuff that's easily verifiable? See for example these news items. Dicklyon (talk) 05:58, 14 June 2008 (UTC)
I went ahead and added a couple of those sources, restoring the brief mention of the petition. There's a lot more from those that could be said, but I didn't work on that, other than using their names instead of titles, and linking the journal that Zucker edits. I agree the second half seemed unverifiable WP:OR; though some of its refs may have been reliable, I didn't see anything about the petition in them. Dicklyon (talk) 06:23, 14 June 2008 (UTC)
It's unclear why "Marion" has again removed the link to the petition, given that the material is sourced and doesn't seem to be at issue. And the only reason she "attributed" the news to one of the two two sources was apparently to link it to a marginalized group. This is bullshit. News is news; if there's a particular point that that article makes, in the way of interpretation or opinion, then attribution makes sense. I'll try to fix it. Dicklyon (talk) 03:29, 15 June 2008 (UTC)
  • Please use language appropriate to WP rather than statements such as "this is bullshit." That is the second time Dicklyon has used that expression in a discussion with me.
  • I removed the petition because it does not beem WP:RS, as I said here.[10] This is my third request that other opinion be sought, such as a third opinion or other WP venue. WP policy is that the burden of proof belongs to the person putting the statement onto the WP page.
  • The text Dicklyon inserted here[11] violates WP:NPOV. It quotes the negative statements reported by the newspaper article while omitting the positive ones in the same article, regarding a controversial topic.

MarionTheLibrarian (talk) 13:52, 15 June 2008 (UTC)

Removal claiming RS problem[edit]

This paragraph keeps getting removed by MarionTheLibrarian:

The appointment, in May 2008, of two of the taskforce members, Kenneth Zucker (editor of the Archives of Sexual Behavior) and Ray Blanchard, has led to an internet petition[1] to remove them.[2] Accoring to Brian Alexander of MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career.[3] According to Duncan Osborne of The Gay City News, "Dr. Ray Blanchard, a psychiatry professor at the University of Toronto, is deemed offensive for his theories that some types of transsexuality are paraphilias, or sexual urges. In this model, transsexuality is not an essential aspect of the individual, but a misdirected sexual impulse.".[4]

Please, if there's a problem with it, tag the relevant statement with citation needed, or take out any part that you believe is not sufficiently referenced. Don't take out the whole thing with no explanation. Dicklyon (talk) 05:57, 16 June 2008 (UTC)


  1. ^ Objection to DSM-V Committee Members on Gender Identity Disorders, last accessed 22.55GMT 10 May 2008.
  2. ^ Lou Chibbaro Jr. (2008-05-30). "Activists alarmed over APA: Head of psychiatry panel favors 'change' therapy for some trans teens". Washington Blade.  line feed character in |title= at position 28 (help)
  3. ^ Alexander, Brian (2008-05-22). "What's 'normal' sex? Shrinks seek definition: Controversy erupts over creation of psychiatric rule book's new edition". MSNBC. Retrieved 2008-06-14. 
  4. ^ Osborne, Duncan (2008-05-15). "Flap Flares Over Gender Diagnosis". Gay City News. Retrieved 2008-06-14. 

More removal and confusing edit comments[edit]

After this edit where it added "According to the Gay City News", TheLibrarian is now complaining about the places where I have added similar attribution. I think it's clear that what's being reported is not opinion, as in the edit above, so I have no problem leaving it out. But that's no reason to blank the whole paragraph as it has done recently. So I've put it back again; where I had attributed authors, I just have the works now; as I said, I don't mind those being removed if anyone cares. It also asserts "BLP violation"; not clear to me how reporting what a newsworthy online petition says is a BLP violation; perhaps someone could add a link to yet another POV on it? Or say more from the cited sources if what is reported now is not balanced? Dicklyon (talk) 03:34, 18 June 2008 (UTC)

Having input from other peole would be a welcome addition.

MarionTheLibrarian (talk) 03:36, 18 June 2008 (UTC)

Yes, I agree, especially since you won't answer the questions about why you keep removing these things and objecting to the sources, attributions, balance, etc., instead of contributing toward fixing it. Dicklyon (talk) 03:39, 18 June 2008 (UTC)

WP is not a newspaper, and I do not believe the item belongs in WP at all. The onus is on you to demonstrate that it does belong; for as long as there is no consensus for inclusion, I need add no further comment. I suggest you try an RfC.
MarionTheLibrarian (talk) 03:45, 18 June 2008 (UTC)

I'm not sure what you mean about a newspaper. Or why you think anyone cares what you believe. If the material is relevant and sourced to reliable sources, you need a better reason than that to remove it. What onus is on me but to write stuff that's verifiable in reliable sources and relevant to the topic of the article? Dicklyon (talk) 03:49, 18 June 2008 (UTC)

You also have an onus to write with NPOV. When a source provides two sides of an issue, it is a violation of NPOV to add to a page only one of those sides. For example, you omit the indications in the very same article of Blanchard himself saying that he is alleged to have views that are exactly opposite to his actual views. That also violates BLP.
MarionTheLibrarian (talk) 03:59, 18 June 2008 (UTC)

You're lecturing me on NPOV? That's funny! Feel free to add some balancing info if you feel it's needed. Dicklyon (talk) 04:25, 18 June 2008 (UTC)
Looking over this, we do not need all the detail - the charge of "junk science" and the defense. We should simply report, in summary fashion rather than via dueling charges and quotes, that there was considerable objection to their appointment (which goes well beyond an Internet petition) because in their careers they had claimed certain transsexual behaviors were disorders (or however we can best report this in neutral fashion). If there is a dispute over how to actually summarize what they had claimed, then we would say that the objection was over a "claimed" or "perceived" bias in their research, or something like that. Wikidemo (talk) 14:57, 18 June 2008 (UTC)
I'm certainly open to any text you might suggest; I doubt Dicklyon would consider anything that I compose.
MarionTheLibrarian (talk) 15:05, 18 June 2008 (UTC)


Obviously this is pretty lengthy now...maybe it should move down the page, maybe to the end. Maybe it needs thinning out. EverSince (talk) 18:13, 5 July 2008 (UTC)

Trademark sentence[edit]

The introduction paragraph says:

The DSM, including DSM-IV, is a registered trademark belonging to the American Psychiatric Association.[3]

Is it necessary to have that statement in the introduction? It is probably not an important fact for most people reading about the DSM Jenever Spirit (talk) 13:26, 10 September 2008 (UTC)

The Encyclopedia of Insanity[edit]

I think that The Encyclopedia of Insanity should be removed from the external links section because it does not seem to be in keeping with the other links in that section. It reads like a highly opinionated piece rather than a considered criticism and it makes gross exaggeration to make a point. For example, where he claims to be paraphrasing the DSM-IV, "You were out of your mind the last time you have a nightmare (307.47)" is factually incorrect (307.47 quite clearly states that one nightmare does not make a disorder). He also hammers home his opinion that therapists will merely use the DSM to make money by repeatedly calling the diagnostic codes "billing codes". Basically it is written as an attack piece rather than as a considered rebuke. I'm not complaining about all the specific criticisms that Davis makes but I am complaining about the tone and style of writing being completely at odds with the other links in the section. Is a literary review of (what at least purports to be) a scientific work really so important that it should be the only review in the external links section?

In short, I think we should instead link to a more thoughtful article exploring the many criticisms of the DSM. "The Encyclopedia of Insanity" could possibly be used as a reference for the criticisms section, but I'm not sure it should have pride of place in the external links section. I fail to see what it adds to the article. Konomios (talk) 00:10, 26 January 2009 (UTC)

Good point, I've added this to the criticism section instead. Xasodfuih (talk) 00:45, 26 January 2009 (UTC)

Recent changes in the Criticism section[edit]

I find the changes and subsections added there generally an improvement, but I wonder if reliability should be discussed together with construct validity under the (newly added) epistemological subheading; I'm not an expert on epistemology, but I think that only construct validity is an epistemological argument while reliability is more of a practical argument. I could be wrong though. Xasodfuih (talk) 19:22, 8 March 2009 (UTC)

You're probably right. I've renamed the section, but hopefully someone will come up with a better name. LSD (talk) 00:42, 9 March 2009 (UTC)
I strongly disagree. I have returned to this page to find the link to the study of the composition of the DSMIV panel only to find that it has been deleted and substituted by a debating piece and an opinion. This sort of vested interest vandalism is something that jeopardises the entire status of Wikipedia and cause me great distress. Wikipedia is in danger of steadily becoming simply another propogandising organ of the newspeak internet. I took the ooportunity to download the paper concerned. I have started to make it a practice to make pdf copies of pages in Wikipedia before they become similarly vandalised but this occurrence reminds me not to become lax in the practice ij the face of commercial censorship. If anyone is interested in the original paper that analysed the DSMIV panel the research paper entitled: "Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry" by Lisa Cosgrove, Manisha Vijayaraghavan, and Lisa Schneider (University of Massachusetts), and Sheldon Krimsky (Tufts University) can be found at: As far as any epistemological argument goes I confess to a profound apathy.

Political Controversies[edit]

That 1974 decision, however, is still challenged by many conservative and religious groups who maintain that homosexuality is in fact a mental disorder.[49]

The source given there says nothing about religious groups considering homosexuality a mental disorder. In fact, it explicitly says "Research on whether homosexuality is a pathological condition is not formally relevant to the moral debate in the church. Psychological abnormality and immorality are two different things, although sometimes they overlap." It mentions morality in the article, but does not classify either way in saying it is a mental disorder. Neither does it say that such a position is held by Christians. This sentence should be changed or eliminated if no reputable source can be given. Kristamaranatha (talk) 22:45, 7 August 2009 (UTC)

Criticims: Comorbidity, NOS, descriptions based on clinical observation rather than pure empirical research[edit]

  • Comorbidity - In psychiatry, psychology and mental health counseling comorbidity refers to the presence of more than one diagnosis occurring in an individual at the same time. In psychiatry, comorbidity does not necessarily imply the presence of multiple diseases, but instead can reflect our current inability to supply a single diagnosis that accounts for all symptoms.[1] On the DSM Axis I, Major Depressive Disorder is a very common comorbid disorder. The Axis II personality disorders are often criticized because their comorbidity rates are excessively high, approaching 60% in some cases, indicating to critics the possibility that these categories of mental illness are too imprecisely distinguished to be usefully valid for diagnostic purposes and, thus, for deciding how treatment resources should be allocated.
  • Problem not otherwise specified (NOS) diagnosis - Vagueness. Clinicians can disagree on ambiguity of criteria for diagnosis. So much overlap between diagnoses, e.g. Eating_disorder_not_otherwise_specified. Huge percentage of clients can be put into this unspecific / atypical box. In most diagnosis criteria there is a NOS category include disorders that do not meet the criteria for a specific disorder.
  • Descriptions of the various disorders are based on the patients who turn up for treatment / psychotherapy and is not necessarily empirically based. The earlier versions of DSM (I & II) were based largely on theoretical models. DSM-III made progress in being based largely on clinical observations rather than empirical evidence theory. [edit] But there is still some criticism that the descriptions of the disorders are not empirically based.

Action potential discuss contribs 10:43, 30 August 2009 (UTC)

The DSM obviously isn't perfect, because psychiatry, like any other study, is a growing science. Comorbidity doesn't need much explication; one disorder can often provoke the next, and an inherited vulnerability (as well as psychological and social factors) can result in more than one disorder. Not otherwise specified is self-explanatory; we have yet to specify. Basically, you're pushing that we haven't done enough research, which will probably always be true. When it comes to descriptions, that isn't entirely true, surveys are often conducted in a non-clinical manner, and I don't really see how else we can come up with enough subjects otherwise, because we would have to look for them (who would often have less drastic cases of disorders, because they haven't gone for treatment/therapy, mostly having felt no need), instead of waiting for them to come to us. A universal question to defend from those criticisms: how else would you have it? MichaelExe (talk) 02:01, 30 August 2009 (UTC)
if you have some sources, you should add this information to the artice. Earlypsychosis (talk) 07:44, 30 August 2009 (UTC)
The second sentence of Validity and reliability (from [12]): "Although increasingly standardized, critics argue that the DSM's claim of an empirical foundation is overstated." So, it's already there. MichaelExe (talk) 20:15, 30 August 2009 (UTC)
Just noticed that there is no coverage of structured interviews which was introduced at DSM-III. This is quite an important advance. ----Action potential discuss contribs 06:57, 31 August 2009 (UTC)

I would start with SCID but diberris tool is not working. Compr Psychiatry. 1994 Jul-Aug;35(4):316-27. Reliability of the Structured Clinical Interview for DSM-III-R: an evaluative review. Segal DL, Hersen M, Van Hasselt VB. PMID: 7956189 Earlypsychosis (talk) 00:07, 1 September 2009 (UTC)


  1. ^ First MB (2005). "Mutually exclusive versus co-occurring diagnostic categories: the challenge of diagnostic comorbidity". Psychopathology. 38 (4): 206–10. doi:10.1159/000086093. PMID 16145276. 

Consumers (term)[edit]

The section Consumers says: "A Consumer is a person who has accessed psychiatric services and been given a diagnosis from the DSM." Is consumer really the best, most standard term? Isn't client or user more common?? Lova Falk talk 17:26, 18 June 2010 (UTC)

client, consumer and service user are all used[citation needed]. I dont think there is a standard term, as the concept seems to be a product of the social and poltical climate of the time. The term client is no longer used in my service - as it is thought to be a product of the 1980s. Earlypsychosis (talk) 08:28, 6 July 2010 (UTC)
Consumer is a horrible word probably of human capital origin; it appears nowhere in the DSM IV TR; if there is no compelling reason to use it, it should soon be changed to the more standard "client."--John Bessa (talk) 18:33, 27 January 2011 (UTC)
Why is this necessary in a discussion about the DSM? I don't see any link. Put this in a general article about Psychiatry. Egmason (talk) 05:53, 13 February 2014 (UTC)
Egmason, the talk page is not a discussion about the DSM but about our article. In the article, the term consumer is used. That is how this is a relevant discussion. Lova Falk talk 08:33, 14 May 2014 (UTC)
I now changed from consumer to client. Lova Falk talk 08:36, 14 May 2014 (UTC)


Unlinked Footnotes Problem[edit]

Footnotes 20-24 referencing DSM-IV Sourcebook Volume 1, Sourcebook Volume 2, Sourcebook Volume 3, and Sourcebook Volume 4 lead nowhere. Pbh444 (talk) 16:06, 17 September 2010 (UTC)

Copyright issues about DMS's contentets[edit]

Do I remember correctly that there were copyright issues, also here in Wikipedia itslef, about DSM's contents? (Issues that point out that DMS's contents are a authors' creations). -- (talk) 10:35, 17 December 2010 (UTC)

It is copyright to the APA with all rights reserved--John Bessa (talk) 21:55, 27 January 2011 (UTC)
Yes, but does'nt it mean that it's APA invention (autohrs' creation)?! This should be pointed out.-- (talk) 07:57, 17 February 2011 (UTC)
p.s. Do I rememebre correctly that even there was a copyright issue between APA and Wikipedia itslef? -- (talk) 07:59, 17 February 2011 (UTC)

Difference between Axis I and II[edit]

I believe that this is a really good topic for discussion, as there is a logic behind it that is not obvious. My view is that Axis II is derived from traits that are life-long, and Axis I is about disorders that are affective (not necessarily, but including depression). I am posing this suggestion as a question, as sources are hard to find concerning this.--John Bessa (talk) 17:19, 15 February 2011 (UTC)

You will find the best description of this in the introduction to The Diagnostic and Statistical Manual of the American Psychiatric Association. Basically they were trying to separate up different aspects of the biopsychosocial-developmental aspects of the diagnosis. Also Axis I is not just 'affective', but all the major disorders. Also, the book itself clearly says if you don't like the multiaxial system, dont use it, and it provides several helpful alternative formats you might like to use. Main problem here is that I bet the minority contributing have the book or have ever read it. Egmason (talk) 05:53, 13 February 2014 (UTC)

Source 53[edit]

I believe that use of this source should be evaluated on the basis that the host cite of the paper presented is incredibly biased in consideration of homosexuality as a mental disorder. NARTH, while claiming to be a genuine, unbiased source, seems quite biased to be perfectly frank. NARTH disagrees with the APA on many issues regarding homosexuality including whether homosexuality is actually an illness. I think that source 53 is heavily filled with said differences and should not be included in a discussion of the DSM unless specific consideration is given to the fact that the information comes from NARTH rather than the APA since the DSM is a work of the APA. I'm not saying that the information given in source 53 should be entirely discredited, just that it should either be clearly stated in the article where the information comes from or that the information should be verified by another source. — Preceding unsigned comment added by Saiuu (talkcontribs) 04:53, 12 April 2011 (UTC)

I added that source a while back and I see that mention of this issue has been deleted now. The source is actually a book entitled Homosexuality: The Use of Scientific Research in the Church's Moral Debate by a PhD provost of Wheaton College and a PhD assistant professor of psychology at Regent University. NARTH happened to have a relevant extract from it on their website. It should have easily been changed; I will use a different link in the citation and will re-add the point.
Btw the reason I see this is as important is that it's also a bias to not want any comparisons made between conceptualisations of homosexuality with what are still considered mental disorders, which in some cases may be because that potentially highlights continuing scientific and political ambiguities and problems with the foundations of the DSM, as well as the partially shared origins and foundations of social movements that otherwise now differ as to whether they still face the task of challenging psychiatric assumptions. Eversense 20:16, 21 December 2011 (UTC)

Edit request on 18 December 2011 (note to administrators - this belongs in the Critique section, thanks!)[edit]

Dr. Ofer Zur and Nola Nordmarken (2010) describe how the DSM pathologizes healthy groups, such as autistics, women, the elderly, and people with strong expressed emotions. Full article here.

Azziaz (talk) 06:57, 18 December 2011 (UTC)

X mark.svg Not done - as it stands its not something I can add to the criticism section. I though about adding it to a created further reading section? But it seems a primary article written by two people that as yet don't have en wikipedia articles. IMO to include this content will need a bit tweaking and or discussion. Youreallycan (talk) 12:52, 21 December 2011 (UTC)

(Note: Just wanted to add a request - I've recently found out that the "belief in supernatural beings, such as ghosts, spirits, angels and demons" was considered a sign of mental illness and incompetency before DSM-IV 1994. Could the experts please confirm this fact and report it in this article?) — Preceding unsigned comment added by Philosopher3000 (talkcontribs) 23:55, 9 March 2012 (UTC)

If that is a delusion, then yes it still is. If you have enough persons who believe, then no, it is religion and obviously not a mental disorder. Egmason (talk) 05:53, 13 February 2014 (UTC)

DSM-IV-TR for free[edit]

Hi. How can I get DSM-IV-TR and get it for free? — Preceding unsigned comment added by Mustafa Bakacak (talkcontribs) 11:07, 27 September 2012 (UTC)

I don't know how you can get the whole book for free, but here you can read about all the diagnoses: [13] Lova Falk talk 19:03, 27 September 2012 (UTC)
Search through second-hand or charity stores in a University town. Go to a library. Ask a psychiatrist if you can have their old copy. Write to the APA and ask. Pirate Bay might have a copy but you might get Digital Millennium Copyright Act-ed. Advertise on e-bay or Craigslist. Ask your local hospital or health provider if they have one they're not using. Egmason (talk) 05:53, 13 February 2014 (UTC)

DSM 5 - "standards"?[edit]

"DSM 5 will accept diagnoses that achieve reliabilities as unbelievably low as 0.2-0.4 (barely beating the level of chance agreement two monkeys could achieve throwing darts at a diagnostic board"[14] - Allen Frances, M.D., was chair of the DSM-IV Task Force ParkSehJik (talk) 06:54, 29 November 2012 (UTC)

Yes, this is a hotly debated issue in the field. There has been and will continue to be a lot written on the topic and it will require in-depth knowledge of the issues involved, multiple sources (peer-reviewed journal articles in particular), and commitment to maintaining a neutral perspective. Mark D Worthen PsyD 09:42, 21 May 2013 (UTC)

DSM v ICD articles, neutrality?[edit]

I was just comparing this article with the one on ICD, and was surprised to find one huge difference. This article is approximately 1/3 criticism of the DSM, including a third of the lede section. The ICD article has no mention of any criticism or controversy until the final sentence. Searches of Google and Pubmed show somewhat higher criticism of DSM versus ICD, but not by a wide margin, and the more sweeping sorts of criticisms made to either, apply to the other. I'm not even going to attempt to evaluate why the articles on very similar publications are so different, but it might be worth pondering. (talk) 22:37, 2 December 2012 (UTC)

GA Review[edit]

This review is transcluded from Talk:Diagnostic and Statistical Manual of Mental Disorders/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Zad68 (talk · contribs) 03:14, 18 January 2013 (UTC)

  • This is the oldest nomination in its GAN grouping and it deserves a look-through. Zad68 03:14, 18 January 2013 (UTC)

Status = NOT PASSED[edit]

  • Starting review... Zad68 03:21, 18 January 2013 (UTC)
  • Review stopped.
  • One confirmed plagiarism issue found and several others suspected.
  • Criticism section takes up nearly half the body of the article, a likely WP:UNDUE problem
  • Bayer source questionable
  • Uses of "claim" and other wording make for WP:POV problems
  • Large sections of text quoted directly from sources, and quoted in a way that modifies the original meaning
  • Also number of (relatively easy to correct) WP:MOS issues

I did not complete the review, as once I saw enough problems, I stopped, so there may also be further issues. This article still needs significant work before GA, starting with rooting out the plagiarism issues, and so it is not being listed for GA. Zad68 04:42, 18 January 2013 (UTC)

GA table[edit]

Rate Attribute Review Comment
1. Well written:
1a. the prose is clear and concise, and the spelling and grammar are correct. Some issues as noted below, including some confirmed and some suspected plagiarism
1b. it complies with the manual of style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. WP:WTW "current", "upcoming", "claim"
2. Verifiable with no original research:
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.
2b. all in-line citations are from reliable sources, including those for direct quotations, statistics, published opinion, counter-intuitive or controversial statements that are challenged or likely to be challenged, and contentious material relating to living persons—science-based articles should follow the scientific citation guidelines.
2c. it contains no original research.
3. Broad in its coverage:
3a. it addresses the main aspects of the topic.
3b. it stays focused on the topic without going into unnecessary detail (see summary style).
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each. uses of WP:WTW "claim", very large and possibly WP:UNDUE Critcism section may not be in line with emphasis found sources (need explanation).
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute. No recent edit-warring and quiet Talk page
6. Illustrated, if possible, by images:
6a. images are tagged with their copyright status, and valid fair use rationales are provided for non-free content.
6b. images are relevant to the topic, and have suitable captions.
7. Overall assessment. Not passed.


MOS compliance[edit]

  • "current" is used several times, this time-dates the article and is a WP:WTW relative time reference problem, eliminate it and date the information appropriately
  • "claim" is WP:WTW, see WP:CLAIM
  • prose close-quotes should have the punctuation inside


  • Ran MadmanBot against the article, came up clean


  • "published by the American Psychiatric Association" should have commas before and after

Uses and definition[edit]

  • "hospitals, clinics, and insurance companies in the US also generally require a 'five axis' DSM diagnosis of all the patients treated" -- not all hospitals? is "psychiatric hospitals..." meant?
  • "The DSM, including DSM-IV, is a registered trademark belonging to the American Psychiatric Association (APA).[3][4]" -- work this info into the other paragraphs in this section so there isn't a single-sentence paragraph
  • consider switching the order of the top and bottom paragraphs here, it would make more sense to start with the fundamental definition before talking about how it's used
  • in the defintion, why is "and that" substituted with "[which]"? And "...death, pain, disability, or an important loss of freedom.” was dropped off the end of that sentence and really can't be because it changes the original meaning in an important way. This makes me suspicious that the "no definition adequately..." content also may be problematic.


  • The first official attempt was the 1840 census which used a single category, "idiocy/insanity". -- consider: The first official attempt was the 1840 census, which used a single category: "idiocy/insanity".
  • This was subsequently revised several times by APA over the years. APA, ... -- Doesn't "APA" need "the" in front of it?
  • The foreword to the DSM-I states the US Navy had itself made some minor revisions but "the Army established a much more sweeping revision, abandoning the basic outline of the Standard and attempting to express present day concepts of mental disturbance. This nomenclature eventually was adopted by all Armed Forces", and "assorted modifications of the Armed Forces nomenclature [were] introduced into many clinics and hospitals by psychiatrists returning from military duty." The Veterans Administration also adopted a slightly modified version of Medical 203. -- this is a large quote from a primary source, can it be paraphrased, also needs refs
  • In 1950 the --> In 1950, the
  • 46% replied, --> Per MOS a sentence shouldn't start with a digit, recast to avoid this
  • 'neurosis' (nervousness, 'egodystonic) --> extra quote? needs cleanup
  • It was quite similar to the DSM-I. --> "quite" sounds editorial here, consider dropping
  • The term "reaction" was dropped --> this is the first time "reaction" is mentioned, what is it and what is the significance of them dropping it?
  • "personality disorders did not experience emotional distress was discarded" is straight plagiarism out of the source and makes me very suspicious about possible plagiarism in the rest of the article
  • The whole Ronald Bayer description is right out of his own book, this source does not seem likely to be impartial to the events



My first observation is that the Criticism section takes up nearly half the body of the article. Is that in line with what is found in reliable sources? I'm not coming into this article knowing a whole lot about the DSM but it is a bit surprising to me to find such a large Criticism section, can you please comment on this?

Excellent point. Parts of the criticism section are very well-written, with several citations to peer-reviewed journal articles, and adopt a balanced, neutral, encyclopeadic approach. Other sections read like an editorial and/or a clearly biased presentation of one side of a debate. Mark D Worthen PsyD 09:50, 21 May 2013 (UTC)
I notice that none of the cited criticisms of DSM V were written after publication in May of 2013, but instead focus on criticism that were written before its release. perhaps criticisms of the document should be focused on articles and citations that appear after final publication. It's not as if there are no critiques writeen in the four months it has been out. — Preceding unsigned comment added by (talk) 15:35, 21 August 2013 (UTC)


See also[edit]

External links[edit]




Sources table

In this table:

  • Source lists the source as cited in the article
  • Seems WP:RS? means, "Does this source appear to meet WP:RS for reliable sourcing?"
  • Use OK? means, is the source used appropriately in the article? For the review, a few selected sources will be spot-checked to ensure they aren't plagiarized and support the article content. ? indicates the source was not spot-checked.
  • Notes will summarize problems found and what needs to be done to fix them
Source Seems WP:RS? Use OK? Notes
<ref name="Revolution">{{Cite journal|doi= 10.1002/jhbs.20103|author=Mayes, R. & Horwitz, AV.|year=2005|title=DSM-III and the revolution in the classification of mental illness|journal=J Hist Behav Sci|pmid= 15981242|volume=41|issue=3|pages=249–67}}</ref> ?
<ref name="concept&evolution">Dalal PK, Sivakumar T. (2009) [ Moving towards ICD-11 and DSM-5: Concept and evolution of psychiatric classification.] Indian Journal of Psychiatry, Volume 51, Issue 4, Page 310-319.</ref> ?
<ref name="Cosgrove">Cosgrove, Lisa, Krimsky, Sheldon,Vijayaraghavan, Manisha, Schneider, Lisa, [ Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry]</ref> ?
<ref name="DSM-5 Publication Date Moved to May 2013">{{cite press release |last= |first= |title=DSM-5 Publication Date Moved to May 2013 |trans_title= |language= |date=December 10, 2009 |publisher=American Psychiatric Association |location=Arlington, VA |url= |format= |accessdate=January 9, 2012 |archiveurl= |archivedate=January 9, 2012 |deadurl=yes |quote= |ref= }}</ref> ?
<ref name="Houts2000">{{cite journal | author = Houts A.C. | year = 2000 | title = Fifty years of psychiatric nomenclature: Reflections on the 1943 War Department Technical Bulletin, Medical 203 | url = | journal = Journal of Clinical Psychology | volume = 56 | issue = 7| pages = 935–967 | doi = 10.1002/1097-4679(200007)56:7<935::AID-JCLP11>3.0.CO;2-8 | pmid = 10902952 }}</ref> ?
<ref name="HumanizingMadness">{{cite book| last = McLaren| first = Niall| title = Humanizing Madness| year = 2007| publisher = Loving Healing Press| location = Ann Arbor, MI| isbn = 1-932690-39-5| pages = 81–94 }}</ref> ?
<ref name="Oldham">{{cite journal|last=John M. Oldham|title=Personality Disorders|journal=FOCUS|year=2005|volume=3|pages=372–382.|url=}}</ref> ?
<ref name="Phillips">{{cite journal|last=Phillips|first=James et al.|title=The Six Most Essential Questions in Psychiatric Diagnosis: A Pluralogue. Part 1: Conceptual and Definitional Issues in Psychiatric Diagnosis|journal=[[Philosophy, Ethics, and Humanities in Medicine]]|year=2012|month=January 13|volume=7|issue=3|pages=1–51|doi=10.1186/1747-5341-7-3|pmid=22243994|url=|accessdate=24 January 2012|publisher=BioMed Central|issn=1747-5341|pmc=3305603|last2=Frances|first2=Allen|last3=Cerullo|first3=Michael A|last4=Chardavoyne|first4=John|last5=Decker|first5=Hannah S|last6=First|first6=Michael B|last7=Ghaemi|first7=Nassir|last8=Greenberg|first8=Gary|last9=Hinderliter|first9=Andrew C}}</ref> ?
<ref name="PMID5774702">{{cite journal | url = | pmid = 5774702 | author-separator =, | author-name-separator= | volume=10 Suppl | year=1969 | month=April | pages=21–9 | last1 = Cooper | first1 = JE | last2 = Kendell | first2 = RE | last3 = Gurland | first3 = BJ | last4 = Sartorius | first4 = N | last5 = Farkas | first5 = T | title = Cross-national study of diagnosis of the mental disorders: some results from the first comparative investigation | journal = The American Journal of Psychiatry}}</ref> ?
<ref name="Poland01vol1">Poland, JS. (2001) [ Review of Volume 1 of DSM-IV sourcebook]</ref> ?
<ref name="Poland01vol2">Poland, JS. (2001) [ Review of vol 2 of DSM-IV sourcebook]</ref> ?
<ref name="titleTrademark''' Electronic Search System (TESS)">{{cite web|url=|title=Trademark Electronic Search System (TESS)|accessdate=2010-02-03}}</ref> ?
<ref name="Transformation">{{cite journal | last1 = Wilson | first1 = M. | date = 1993 March; | title = DSM-III and the transformation of American psychiatry: a history | url = | journal = Am J Psychiatry | volume = 150 | issue = 3| pages = 399–410 | pmid = 8434655 }}</ref> ?
<ref name="wash-post">Shankar Vedantam, [ Psychiatry's Missing Diagnosis: Patients' Diversity Is Often Discounted] Washington Post: Mind and Culture, June 26</ref> ?
<ref name="Widiger2000">{{cite journal |author=Widiger TA, Sankis LM |title=Adult psychopathology: issues and controversies |journal=Annu Rev Psychol |volume=51 |issue= |pages=377–404 |year=2000 |pmid=10751976 |doi=10.1146/annurev.psych.51.1.377 }}</ref> ?
<ref>[ DSM-IV Sourcebook Volume 4]</ref> ?
<ref>[ How Using the Dsm Causes Damage: A Client’s Report] Journal of Humanistic Psychology, Vol. 41, No. 4, 36-56 (2001)</ref> ?
<ref>[ The National Psychologist (Susan Bowman, 2006)]</ref> ?
<ref>[ Dominic Murphy, PhD; Steven Stich, PhD (1998) Darwin in the Madhouse]</ref> ?
<ref>[ 81 Words. The Inside Story of Psychiatry]</ref> ?
<ref>[ DSM-IV Sourcebook Volume 1]</ref> ?
<ref>[ DSM-IV Sourcebook Volume 2]</ref> ?
<ref>[ DSM-IV Sourcebook Volume 3]</ref> ?
<ref>[ DSM-5 development]</ref> ?
<ref>[ What is the Reliability of the SCID-I?]</ref> ?
<ref>[ What is the "validity" of the SCID-I?]</ref> ?
<ref>[ G. Scott Sparrow: DSM-IV-TR In Action]</ref> ?
<ref>[ DSM-II Homosexuality Revision]</ref> ?
<ref>Alexander, B. (2008) [ What's ‘normal’ sex? Shrinks seek definition Controversy erupts over creation of psychiatric rule book's new edition] MSNBC Today, May.</ref> ?
<ref>Allen Frances, Avram H. Mack, Ruth Ross, and Michael B. First (2000) [ The DSM-IV Classification and Psychopharmacology].</ref> ?
<ref>Allen, FJ. (2012) [ Is DSM 5 A Public Trust Or An APA Cash Cow? Commercialism And Censorship Trump Concern For Quality] Psychology Today</ref> ?
<ref>American Psychological Association: [ Appropriate Therapeutic Responses to Sexual Orientation]</ref> ?
<ref>APA [ Summary of Practice-Relevant Changes to the DSM-IV-TR].</ref> ?
<ref>Bhugra, D. & Munro, A. (1997) ''Troublesome Disguises: Underdiagnosed Psychiatric Syndromes'' Blackwell Science Ltd</ref> ?
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<ref>Spitzer and First (2005) [ Classification of Psychiatric Disorders.] JAMA.2005; 294: 1898-1899.</ref> ?
<ref>Spitzer, Robert L, M.D., Williams, Janet B.W, D.S.W., First, Michael B, M.D., Gibbon, Miriam, M.S.W., [ Biometric Research]</ref> ?
<ref>{{cite book| author = Stanton L. Jones| coauthors = Mark A. Yarhouse| title = Homosexuality: The Use of Scientific Research in the Church's Moral Debate| url =| date = 2000-11-06| publisher = InterVarsity Press| isbn = 978-0-8308-1567-8 }}</ref> ?
<ref>{{cite book| last = Lane| first = Christopher| title = Shyness: How Normal Behavior Became a Sickness| year = 2007| publisher = Yale University Press| isbn = 0-300-12446-5| page = 263 }}</ref> ?
<ref>{{cite journal | last1 = Bentall | first1 = R. | year = 2006 | title = Madness explained : Why we must reject the Kraepelinian paradigm and replace it with a 'complaint-orientated' approach to understanding mental illness | url = | journal = Medical hypotheses | volume = 66 | issue = 2| pages = 220–233 | doi = 10.1016/j.mehy.2005.09.026 | pmid = 16300903 }}</ref> ?
<ref>{{cite journal | last1 = Krueger | first1 = RF. | last2 = Watson | first2 = D. | last3 = Barlow | first3 = DH. ''et al.'' | year = 2005 | title = Introduction to the Special Section: Toward a Dimensionally Based Taxonomy of Psychopathology | url = | journal = Journal of Abnormal Psychology | volume = 114 | issue = 4| pages = 491–493 | doi = 10.1037/0021-843X.114.4.491 | pmid=16351372 | pmc=2242426}}</ref> ?
<ref>{{cite journal | last1 = Pincus | first1 = H. A.| author-separator =, | author-name-separator= | year = 1998 | title = Clinical Significance" and DSM-IV | url = | journal = Arch Gen Psychiatry | volume = 55 | issue = 12| page = 1145 | pmid = 9862559 | doi = 10.1001/archpsyc.55.12.1145 | last2 = Zarin | first2 = DA | last3 = First | first3 = M | pages = 1145; author reply 1147–8 }}</ref> ?
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<ref>{{cite journal | last1 = Wakefield | first1 = Jerome C. | last2 = PhD | first2 = MF| last3 = PhD | first3 = MB| last4 = PhD | first4 = DSW | last5 = Schmitz | first5 = Mark F. | last6 = First | first6 = Michael B. | last7 = MD | first7 = | last8 = Horwitz | first8 = Allan V. | year = 2007 | title = Extending the Bereavement Exclusion for Major Depression to Other Losses: Evidence From the National Comorbidity Survey | url = | journal = Arch Gen Psychiatry | volume = 64 | issue = 4| pages = 433–440 | doi = 10.1001/archpsyc.64.4.433 | pmid = 17404120 }}</ref> ?
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<ref>{{cite journal|last=Cosgrove|first=Lisa|coauthors=Krimsky, Sheldon, Vijayaraghavan, Manisha, Schneider, Lisa|title=Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry|journal=Psychotherapy and Psychosomatics|year=2006|volume=75|issue=3|pages=154–160|doi=10.1159/000091772|pmid=16636630}}</ref> ?
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<ref>{{cite web|title=Schizophrenia and Other Psychotic Disorders|url=|publisher=American Psychiatric Association|accessdate=May 6, 2010}}</ref> ?
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<ref>{{cite web|url= |title=DSM: Frequently Asked Questions | | |date= |accessdate=2012-11-25}}</ref> ?

Post-GA suggestions[edit]

Section 5.1 - Criticism: Political Controversies - Eliminate this subsection?[edit]

==> Please see 44.2 CONSENSUS, below, for a summary of the consensus reached. Also, please see 44.2.1 Adding Back the "Political Controversies" subsection and its contents, below, if you disagree.[Edit]

I would like to reach We have reached consensus on two issues: [Edit]

1) Is the information currently in Section 5.1- Criticism: Political Controversies important enough to include in this article?

2) If so, should it remain in its own subsection or should it be integrated elsewhere in the article?

  • My answer to #1: No. This is a 'settled issue' for almost all mental health and medical professionals. I do not know of any major mental health or medical association that still believes that homosexuality is a mental disorder.
    • Willingness to compromise: Having stated my personal view, let me acknowledge that some editors believe this information is important. Along those lines, I understand that there are a few small, religiously oriented mental health and medical groups, which argue that homosexuality is a mental illness. And there are presumably a small number of mental health and medical professionals who hold that view. Therefore, in an effort to be as balanced, objective, and neutral as possible, I would support inclusion of such information in the article, with two important provisos.
      • Proviso A: The amount of space such information takes up in the article, and the extent to which it receives signs of prominence, would not exceed its current level of acceptance among mental health and medical professionals.
      • Proviso B: In a footnote or other suitable reference, immediately associated with that information, we would note that the American Psychiatric Association[1], American Psychological Association[2], American Academy of Pediatrics[3], and other professional associations[4] have issued official statements, scientific literature reviews, and fact sheets explaining their conclusions that homosexuality is not a mental disorder. Furthermore, it should be noted that the American Psychological Association[5] , American Psychiatric Association[6], American Medical Association[7], American Psychoanalytic Association[8], American School Counselor Association[9], American Academy of Pediatrics[10], National Association of Social Workers[11], and the Pan American Health Organization[12] (a regional office of the World Health Organization) have published official statements regarding the lack of scientific evidence that so-called conversion therapy works and the impropriety of mental health or medical professionals seeking to change a person's sexual orientation.
  • My answer to #2: Information about the minority opinion, viz., that homosexuality is a mental disorder, should not be placed in its own subsection. The belief that homosexuality is a mental disorder is a small, minority opinion that perhaps should be mentioned, but giving this argument it's own subsection connotes more prominence and consensus to the belief than is warranted.
    • I do believe it is important to mention the DSM's evolution regarding the status of homosexuality as a mental disorder (or not), but such a review already exists inSection 2: History.

What do you think?


  1. ^ American Psychiatric Association - LGBT-Sexual Orientation "Is Homosexuality A Mental Disorder? No. All major professional mental health organizations have gone on record to affirm that homosexuality is not a mental disorder. In 1973 the American Psychiatric Association’s Board of Trustees removed homosexuality from its official diagnostic manual, The Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM II). The action was taken following a review of the scientific literature and consultation with experts in the field. The experts found that homosexuality does not meet the criteria to be considered a mental illness."
  2. ^ American Psychological Association, Sexual orientation and homosexuality "Is homosexuality a mental disorder? No, lesbian, gay, and bisexual orientations are not disorders. Research has found no inherent association between any of these sexual orientations and psychopathology. Both heterosexual behavior and homosexual behavior are normal aspects of human sexuality. Both have been documented in many different cultures and historical eras. Despite the persistence of stereotypes that portray lesbian, gay, and bisexual people as disturbed, several decades of research and clinical experience have led all mainstream medical and mental health organizations in this country to conclude that these orientations represent normal forms of human experience. Lesbian, gay, and bisexual relationships are normal forms of human bonding. Therefore, these mainstream organizations long ago abandoned classifications of homosexuality as a mental disorder."
  3. ^ American Academy of Pediatrics - Gay, Lesbian, and Bisexual Teens: Facts for Teens and Their Parents "Am I normal? Homosexuality is not a mental disorder. All of the major medical organizations, including The American Psychiatric Association, The American Psychological Association, and the American Academy of Pediatrics agree that homosexuality is not an illness or disorder, but a form of sexual expression."
  4. ^ Health Professionals Advancing LGBT Equality (previously known as the Gay & Lesbian Medical Association), Compendium of Health Profession Association LGBT Policy & Position Statements
  5. ^ American Psychological Association Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts "Be it further resolved that the American Psychological Association concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation; Be it further resolved that the American Psychological Association encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others’ sexual orientation;"
  6. ^ American Psychiatric Association: LGBT-Sexual Orientation "Is It Possible To Change One’s Sexual Orientation ('Reparative Therapy')? There is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change one’s sexual orientation, nor is it included in the APA’s Task Force Report, Treatments of Psychiatric Disorders. More importantly, altering sexual orientation is not an appropriate goal of psychiatric treatment. ... A position statement adopted by the Board in December 1998 said: 'The American Psychiatric Association opposes any psychiatric treatment, such as 'reparative' or “'onversion”' therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/ her homosexual orientation.'”
  7. ^ Policies on GLBT Issues, Patient-centered policies, H-160.991 "[AMA] opposes the use of 'reparative' or 'conversion' therapy that is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation."
  8. ^ Psychoanalytic Association, Position Statements, Attempts to Change Sexual Orientation "Psychoanalytic technique does not encompass purposeful attempts to “convert,” “repair,” change or shift an individual’s sexual orientation, gender identity or gender expression. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized attitudes."
  9. ^ School CounselorAssociation, The Professional School Counselor and LGBTQ Youth, The Professional School Counselor’s Role "The professional school counselor works with all studentsthrough the stages of identity development and understands this development may be more difficult for LGBTQ youth. It is not the role of the professional school counselor to attempt to change a student’s sexual orientation/gender identity but instead to provide support to LGBTQ students to promote student achievement and personal well-being."
  10. ^ AMERICAN ACADEMY OF PEDIATRICS, Sexual Orientation and Adolescents "Human sexual orientation most likely exists as a continuum from solely heterosexual to solely homosexual. In 1973, the American Psychiatric Association reclassified homosexuality as a sexual orientation or expression and not a mental disorder.12 The mechanisms for the development of a particular sexual orientation remain unclear, but the current literature and most scholars in the field state that one’s sexual orientation is not a choice; that is, individuals do not choose to be homosexual or heterosexual."
  11. ^ National Association of Social Workers, Position Statement, "Reparative" and "Conversion" Therapies for Lesbians and Gay Men "People seek mental health services for many reasons. Accordingly, it is fair to assert that lesbians and gay men seek therapy for the same reasons that heterosexual people do. However, the increase in media campaigns, often coupled with coercive messages from family and community members, has created an environment in which lesbians and gay men often are pressured to seek reparative or conversion therapies, which cannot and will not change sexual orientation. Aligned with the American Psychological Association’s (1997) position, NCLGB believes that such treatment potentially can lead to severe emotional damage. ... NCLGB asserts that conversion and reparative therapies are an infringement to the guiding principles inherent to social worker ethics and values.
  12. ^ Pan American Health Organization, "Therapies" to change sexual orientation lack medical justification and threaten health "Services that purport to 'cure' people with non-heterosexual sexual orientation lack medical justification and represent a serious threat to the health and well-being of affected people..."

Mark D Worthen PsyD 13:46, 22 May 2013 (UTC)

Be bold, make the edits! The article needs a lot of help and it doesn't appear that anybody else is interested in editing it right now. Zad68 01:21, 23 May 2013 (UTC)
Thanks for the nudge. :o) I started to do just what you suggest tonight but then I got myself sidetracked on the DSM-5 article. But I shall return! Mark D Worthen PsyD 07:28, 23 May 2013 (UTC)
And actually we should not be modifying this closed GA review page anymore, please use the normal article Talk page,Talk:Diagnostic_and_Statistical_Manual_of_Mental_Disorders. Zad68 01:27, 23 May 2013 (UTC)
Isn't this the normal Talk page? It looks like it is, e.g., at the top of my edit window it says, "Editing Talk:Diagnostic and Statistical Manual of Mental Disorders/GA1 (section)." Mark D Worthen PsyD 07:28, 23 May 2013 (UTC)
Ah, I get what you're saying now. Moved accordingly. :^) Mark D Worthen PsyD 07:34, 23 May 2013 (UTC)


We have reached consensus that reference to homosexuality as a mental disorder should be integrated into the article in a relevant section and, to the extent that such additions refer to contemporary (i.e., in 2013) assertions that homosexuality is a mental disorder, such additions should be made in a manner that does not accord the viewpoint undue emphasis (WP:UNDUE), i.e., space and prominence in the article that is out of proportion with its:

> small number of adherents
> lack of acceptance by any major mental health or medical professional association
> little, if any, empirical basis

Mark D Worthen PsyD 05:03, 24 May 2013 (UTC)

Adding Back the "Political Controversies" subsection and its contents[edit]

If you believe that the "Political Controversies" subsection should be restored with some or all of the material that had been included, please first discuss your proposal here before editing the page.

In your discussion, please explain why restoring that subsection, including all or most of its content, is important in light of:

  • The information I presented above;
  • The additions made between 01:29 and 02:28 UTC on 24 May 2013 by Johnfos;
  • The many problems with the subsection as it was written (please see the article as of 11:04 UTC on 23 May 2013).

Mark D Worthen PsyD 04:59, 24 May 2013 (UTC)

Article needs much work[edit]

It strikes me that there are particular problems with POV, for two reasons: the Criticisms are pushed to the end of the article instead of being integrated in a balanced way throughout the text. Authors such as Prof Stuart A. Kirk (UCLA), who have said a lot about the DSM over many decades, are not mentioned. Kirk wrote The Selling of the DSM in 1992, and his most recent book Mad Science (2013) also extensively reviews DSM history. I don't plan to get involved in editing this article in a major way, but will add a few paragraphs in the first half of the article that might help to balance it and make it a little more comprehensive. Johnfos (talk) 00:52, 24 May 2013 (UTC)

I agree wholeheartedly and I very much appreciate your additions, Johnfos. IMHO, they are well-placed, pithy, pertinent, balanced, and nicely referenced. Mark D Worthen PsyD 04:03, 24 May 2013 (UTC)
Many thanks, Mark, good to work with you... Johnfos (talk) 09:16, 24 May 2013 (UTC)

The criticism section is really bad[edit]

I'm going to point out some of the problems with the criticism section. It's really bad and needs a lot of work. I would suggest deleting it or cutting it down until it is fixed.

Reliability and Validity Concerns[edit]

The revisions of the DSM from the 3rd Edition forward have been mainly concerned with diagnostic reliability--the degree to which different diagnosticians agree on a diagnosis. (no source)

It was argued that a science of psychiatry can only advance if diagnosis is reliable. (by who?)

If clinicians and researchers frequently disagree about a diagnosis with a patient, then research into the causes and effective treatments of those disorders cannot advance. (no source - who said this? - it doesn't even really make sense because research specifically lists the inclusion criteria. This is true for all medical research.)

Hence, diagnostic reliability was a major concern of DSM-III. (Who was concerned?)

When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria. (source?)

Unfortunately, neither the issue of reliability (accurate measurement) or validity (do these disorders really exist) was settled. (source? Also reliability is and validity are not correctly defined)

However, most psychiatric education post DSM-III focused on issues of treatment--especially drug treatment--and less on diagnostic concerns. (source?)

In fact, Thomas R. Insel, M.D., Director of the NIMH, has recently stated the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity. (In fact? Is that meant to be proof?)

Superficial symptoms[

By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect them together based on statistical or clinical patterns. As such, it has been compared to a naturalist’s field guide to birds, with similar advantages and disadvantages.[43] The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. As DSM-III chief architect Robert Spitzer and DSM-IV editor Michael First outlined in 2005, "little progress has been made toward understanding the pathophysiological processes and etiology of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."[44] (can you use letters to the editor as a source?)

The DSM's focus on superficial symptoms is claimed to be largely a result of necessity (assuming such a manual is nevertheless produced), since there is no agreement on a more explanatory classification system.[citation needed]

Reviewers note, however, that this approach is undermining research, including in genetics, because it results in the grouping of individuals who have very little in common except superficial criteria as per DSM or ICD diagnosis.[3](where does the source say this?)

Despite the lack of consensus on underlying causation, advocates for specific psychopathological paradigms have nonetheless faulted the current diagnostic scheme for not incorporating evidence-based models or findings from other areas of science. (source?)

A recent example is evolutionary psychologists' criticism that the DSM does not differentiate between genuine cognitive malfunctions and those induced by psychological adaptations, a key distinction within evolutionary psychology, but one widely challenged within general psychology.[45][46][47] Another example is a strong operationalist viewpoint, which contends that reliance on operational definitions, as purported by the DSM, necessitates that intuitive concepts such as depression be replaced by specific measurable concepts before they are scientifically meaningful. One critic states of psychologists that "Instead of replacing 'metaphysical' terms such as 'desire' and 'purpose', they used it to legitimize them by giving them operational definitions...the initial, quite radical operationalist ideas eventually came to serve as little more than a 'reassurance fetish' (Koch 1992) for mainstream methodological practice."[48]

Dividing lines

Despite caveats in the introduction to the DSM, it has long been argued (by who?)

that its system of classification makes unjustified categorical distinctions between disorders, and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM syndromes, or between a common DSM syndrome and normality, have failed.[3] Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.[49][50][51][52]

In addition, it is argued (by who?)

that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.[53][54] The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.

Because an individual's degree of impairment is often not correlated with symptom counts, and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.[55] On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life. (Every test in medicine has false positives and false negatives. What's the point of this section?)

Cultural bias

Some psychiatrists also argue that current diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.[56] Advocating a more culturally sensitive approach to psychology, critics such as Carl Bell and Marcello Maviglia contend that the cultural and ethnic diversity of individuals is often discounted by researchers and service providers.[57] In addition, current diagnostic guidelines have been criticized as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criteria set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.[56] Cross-cultural psychiatrist Arthur Kleinman contends that the Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.[58] Kleinman's negative view towards the culture-bound syndrome is largely shared by other cross-cultural critics, common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.[59] Many mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of the DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.[56]

Medicalization and financial conflicts of interest

It has also been alleged (by who?) that the way the categories of the DSM are structured, as well as the substantial expansion of the number of categories, are representative of an increasing medicalization of human nature, which may be attributed (by who?) to disease mongering by psychiatrists and pharmaceutical companies, the power and influence of the latter having grown dramatically in recent decades (according to who?).[60]

Of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had had financial relationships with the pharmaceutical industry at one time, raising the prospect of a direct conflict of interest.[61] The same article concludes that the connections between panel members and the drug companies were particularly strong in those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.[61] In 2005, then American Psychiatric Association President Steven Sharfstein released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".[62] (It seems that if we're going to have a section questioning the use of prescription drugs then we should have a discussion about all the research that is preformed to balance out what is really an ad hominem attack)

However, although the number of identified diagnoses has increased by more than 200% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argue it almost entirely represents greater specification of the forms of pathology, thereby allowing better grouping of more similar patients.[3] William Glasser, however, refers to the DSM as "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".[63]

In addition, the publishing of the DSM, with tightly guarded copyrights, has in itself earned over $100 million for the American Psychiatric Association.[64] (What is the purpose of this line? It appears to be to question the motives of the APA. If that's going to be done, then do it, and back it up with something. Instead this line makes it seem like it's somehow immoral to publish books.)

Consumers and survivors

A consumer is a person who accesses psychiatric services and may have been given a diagnosis from the Diagnostic and Statistical Manual of Mental Disorders, while a survivor self-identifies as having survived psychiatric intervention and the mental health system (which may have involved involuntary commitment and involuntary treatment). (According to who - these are not commonly used descriptions in psychiatry - seems 100% POV)

Some are relieved to find that they have a recognized condition to which they can give a name. Indeed, many people self-diagnose. Others, however, feel they have been given a "label" that invites social stigma and discrimination (i.e. mentalism), or one that they simply do not feel is accurate. Diagnoses can become internalized and affect an individual's self-identity, and some psychotherapists find that this can worsen symptoms and inhibit the healing process.[65]

Some in the Psychiatric survivors movement (more broadly the consumer/survivor/ex-patient movement) actively campaign against their diagnosis, or its assumed implications, and/or against the DSM system in general.

It has been noted that the DSM often uses definitions and terminology that are inconsistent with a recovery model, and that can erroneously imply excess psychopathology (e.g. multiple "comorbid" diagnoses) or chronicity.[66] (This line makes no sense. It's saying that people who disagree with psychiatry disagree with what psychiatrists do - not really needed)

DSM-5 Critiques

Psychiatrist Allen Frances has been critical of proposed revisions to the DSM-5. In a 2012 article, Frances warned that if this DSM version is issued unamended by the APA, it will "medicalize normality and result in a glut of unnecessary and harmful drug prescription."[67] In a December 2, 2012 blog post in Psychology Today, Frances lists the ten "most potentially harmful changes" to DSM-5:[68]

Disruptive Mood Dysregulation Disorder, for temper tantrums
Major Depressive Disorder, includes normal grief
Minor Neurocognitive Disorder, for normal forgetting in old age
Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants
Binge Eating Disorder, for excessive eating
Autism change, reducing the numbers diagnosed
First time drug users will be lumped in with addicts
Behavioral Addictions, making a "mental disorder of everything we like to do a lot."
Generalized Anxiety Disorder, includes everyday worries
Post-traumatic stress disorder, changes opening "the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."

(This is deceptively worded - it makes it sound like the DSM-5 is including temper tantrums under disruptive mood dysregulation disorder [and so on]. This is not an established fact, but one guys opinion of what would happen)

Frances and others have published debates on what they see as the six most essential questions in psychiatric diagnosis:[69]

are they more like theoretical constructs or more like diseases
how to reach an agreed definition
whether the DSM-5 should take a cautious or conservative approach
the role of practical rather than scientific considerations
the issue of use by clinicians or researchers
whether an entirely different diagnostic system is required.  (This would be good in an article about Frances)

In 2011, psychologist Brent Robbins co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Approximately 14,000 individuals and mental health professionals have signed a petition in support of the letter. Thirteen other American Psychological Association divisions have endorsed the petition.[70] Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.[71] (I'm not sure if this is a specific enough criticism to be included. Any diagnostic criteria for anything will have false positives and/or false negatives - also this ignores the role of the physician as any decent physician would get a history)

I think the section should be taken out or pruned until someone has a chance to go through and fix it. Whoever does should ask themselves if this is the right article for each bit of information, if it represents a POV, and if it's properly sourced.

You make some valid points but you lose some credibility by not signing your post and not registering for the site. I see lots of 'fly by' editors with these characteristics. Since I'll often never see such ediotrs again, I don't want to waste time engaging in a dialogue. So, please register for the site and let us know if this was a one-time contribution or if you plan to stick around and work on this issue in a collaborative manner. If you plan to stick around, please read the introductory material for editors on the site - it is very helplful. Then you can make some of the changes you propose yourself. :) Best Regards - Mark D Worthen PsyD 20:26, 2 August 2013 (UTC)

Why the repeated focus on sexuality?[edit]

The sections on the first two editions on the DSM seem to pick out homosexuality in particular as a focus. The section of the second edition's seventh printing is written in such a way as to suggest that homosexuality was removed purely due to political pressure. And the section on DSM-III-R also picks out sexual orientation. It seems that the focus on sexuality throughout these sections and the misleading account of homosexuality being removed are driven by a conservative agenda. — Preceding unsigned comment added by (talk) 14:10, 21 September 2013 (UTC)

Asperger's and Diagnostic and Statistical Manuel of Mental Disorders[edit]

I believe it is necessary to mention that Aspergers was first recognized by the DSM-IV. It is a popular topic amongst society and its origination should be noted. Here is my hopeful addition: The DSM-IV was also the first to recognize Asperger's Syndrome as one of the five disorders listed under the category of pervasive developmental disorder. Here is the citation to the book where I found this information: Grandin, Temple, and Richard Panek. The Autistic Brain: Thinking across the Spectrum. Boston: Houghton Mifflin Harcourt, 2013. Print.

Let me know what you think! --Rzelmano1221 (talk) 23:24, 18 April 2014 (UTC)

Hi Rzelmano1221! Thank you for your suggestion, but personally I think this is too detailed information about one single diagnosis for this article. There are many more diagnoses that have started in one edition of the DSM and that were abandonned in the next edition. Lova Falk talk 08:39, 14 May 2014 (UTC)

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Inconsistencies in description of number of mental disorders listed in each DSM version[edit]

I want to find the number of mental disorders listed in each DSM version.

At present there are some inconsistencies in the way this is described:

  • DSM-I: "106 mental disorders"
  • DSM-II: "182 disorders"
  • DSM-III: "265 diagnostic categories"
  • DSM-IIIR: "292 diagnoses"
  • DSM-IV: "297 disorders"
  • DSM-IV-TR: "The diagnostic categories ... were unchanged." but later in the article: "the number of identified diagnoses ... 365 in DSM-IV-TR"
  • DSM-V: Not specified

I'd like the article to:

  • Use consistent terminology (are they mental disorders, disorders, diagnostic categories, or diagnoses?) in each case.
  • Be specific and consistent about how many mental disorders are listed in the DSM-IV-TR (is it 297 or 365?).
  • Include the number of mental disorders in DSM-V.
  • Summarize this information in a table and/or graph.

--Grahamstoney (talk) 03:22, 24 July 2015 (UTC)

You make some good, valid points. Be bold and make some edits to the article yourself. Your contributions are appreciated. :O) Mark D Worthen PsyD 16:28, 24 August 2015 (UTC)


is out of body experience is a disorder? — Preceding unsigned comment added by (talk) 09:56, 20 August 2015 (UTC)

It can either be a spiritual experience, a symptom of a mental disorder, or if chronic and severe enough, Depersonalization-derealization disorder, which is included in DSM-5 (ICD-9-CM 300.6; ICD-10-CM F48.1). The Wikipedia article, Depersonalization, provides a good introduction IMHO. Mark D Worthen PsyD 16:25, 24 August 2015 (UTC)

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Criticisms - #2[edit]

I find this article disappointing. I have only a layman's knowledge of psychiatry and psychology, but have some hopefully constructive criticisms. First, and most obvious is why are all five editions (as well as supplementary publications which are generally included) treated the same? There has been enormous changes in the DSM's content and uses; is it USEFUL or INFORMATIVE to discuss them as being parts of a single thing? Second, it would be useful to discuss the major alternatives to the Euro-centric? DSM (including the ICD, Ch. V) used by mental health practitioners the world over. (Does China use the DSM? India? Indonesia? Brazil? Pakistan? (those countries and the USA comprise ½ of the world population. How about (other) Islamic, Arabic, or African countries?) Third, the section titled "DSM-5 critiques" was written PRIOR to it being published (May 2013) and should be revised. Any claims before that time were speculative predictions; and are of limited relevance, imho. NOWHERE in that section is mention of the petition (Oct 2013) for outside review mentioned, for example. Lastly, the section titled "Reliability and validity concerns" should be rewritten. Here is my suggested revision:"The DSM's diagnostic reliability — the degree to which different diagnosticians agree on a diagnosis - continues to be a major source of concern.[55] If clinicians often differ in their diagnosis of a patient, or of the criteria which they use to categorize mental disorders, then treatment may not be optimum. Misdiagnosis can lead to both sub-optimal treatment as well as limiting insurance reimbursements for (hence access to) care. In 2013, Thomas R. Insel, M.D., Director of the NIMH, stated that the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity.[56] NIMH has proposed use of the RDoC classification system as an alternative." (talk) 07:01, 29 June 2016 (UTC)

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