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There’s no question that the mental health treatment community — as well as society at large — is always learning about mental illness. Every year, new research comes out that shifts our thinking slightly about certain conditions. These changes may be so incremental we hardly notice them. But a look back at how the DSM-5 came to be can reveal a lot.
In general, the Diagnostic and Statistical Manual (DSM) contains the critical information and diagnostic criteria that health care providers use to care for their patients. It’s been invaluable in helping expand our understanding of certain mental illnesses.
In this piece, we’ll examine the history of the DSM. We’ll also look at how it came to be the defining authority in the mental health treatment space.
What Is the DSM?
DSM stands for Diagnostic and Statistical Manual of Mental Disorders. It’s the nation’s foremost resource for categorizing mental illnesses and lays out diagnostic standards and treatment practices. It’s used by psychological practitioners around the country, as well as many doctors and health care workers.
How DSM Defines Mental Health
Probably the most notable way in which the DSM has defined mental health care is as the basis for most diagnoses. Mental health disorders can be difficult to diagnose accurately. The reason for this is that two different conditions can manifest in almost exactly the same way.
Take schizophrenia, for example. It’s a disease that’s still commonly misdiagnosed, but accurate diagnoses now occur more frequently and earlier than before. With the help of the DSM-5, people who suffer from this disorder are now getting the help they need.
New DSM editions will continue to aggregate more information about rare and hard-to-diagnose diseases. This is good news for individuals who would otherwise visit multiple practitioners, trying to solve the mystery of their condition.
But, how did the DSM come to exist, and how was the edition we use today developed?
Mental Health Before World War II
By the late 19th century, society was finally starting to understand mental illness. People who previously would be classified as insane were now being put into more specific categories.
Targeting early treatments to documented conditions made a major difference, but there was still a problem: There were no standardized resources. The treatments offered were often vastly different from place to place. This made it difficult for patients to get the consistent quality of care needed to recover successfully.
In the late 1910s, the group that would become the American Psychological Association (APA) took on an ambitious project. It partnered with the Census Bureau to compile data on health care across the country. This resulted in the first edition of the International Classification of Diseases (ICD).
The ICD was a full catalog of all diseases, but World War II changed the public perception of mental health. To aid returning veterans dealing with mental illness, the VA pushed to have the ICD’s sixth edition focus more on mental health.
From this push came the first edition of the DSM in 1952. Subsequent editions have been compiled and published by the APA, culminating in the fifth version in use today.
What Has Changed From the First Edition to the DSM-5?
Between 1952 and 2013, when the most recent version of the DSM was published, a lot changed. When the first DSM was compiled, diagnoses that are common now — bipolar disorder, anxiety, depression, etc. — didn’t even exist.
The latest version is also much more detailed in terms of diagnostic standards and effective treatments. As a result, more patients have had access to higher-quality support than ever before. This is especially true with rarer and more complex disorders that were only documented in the decade prior to DSM-5.
Do We Know Everything Now?
Certainly not. Even the fifth version of the DSM introduced and adapted definitions of disorders and conditions. These changes included:
- Binge eating disorder (BED). This common eating disorder was classified much later than bulimia and anorexia, and it revealed a major area of gender inequality. While bulimia and anorexia occur mainly in women, men account for 40% of all BED cases.
- New withdrawal designations. Withdrawal from drugs like caffeine and marijuana have been overlooked in the past. When the DSM-5 added them, it greatly increased awareness of the potential risks of abusing these substances.
- Hoarding disorder: Often ridiculed as the subject of reality television shows, the addition of hoarding to the DSM-5 demonstrated that this condition isn’t a joke.
- Narrowing of conditions. When conditions are broad, they’re harder to treat effectively. DSM-5 defined subtypes of some common conditions, which has allowed patients to be better understood by their doctors. For example, the latest version separated premenstrual dysphoric disorder — a type of depression — from PMS.
The DSM and psychology are strongly linked in that they both move each other forward. And, we still have a lot to learn about human psychology. This suggests that there are many updates to come.
Expected Changes in the Next DSM
The next edition of the DSM will likely adjust the language surrounding certain disorders based on information gleaned since it was last published. We also expect new or narrowed definitions and diagnostic standards to be included.
Changes in the effective treatments for various conditions will also likely be a focus in the next version. With advancements in technology, the field of mental health care has come a long way. At FHE Health, we’ve adopted several exciting, cutting-edge solutions that have shown early promise. We hope the DSM-6 (or DSM-5.1) introduces some of the latest research and new frontiers in treatment.
We also hope that the next edition acknowledges the racial bias that has long existed in the health care space. We believe every person should have equal access to support when and where they need it.
Get Help For a Range of Conditions at FHE Health
If there’s one thing we know about mental illness, it’s that it doesn’t discriminate. Mental health issues can affect anyone. If you or a loved one needs help, regardless of the condition, contact us at FHE Health by calling (833) 596-3502.
