Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders ( Diagnostic and Statistical Manual of Mental Disorders ) is a classification system of the American Psychiatric Association (American Psychiatric Association ), which has first issued in 1952 in the United States. Since then, other countries will appear: For example, it has been around since 1996, a German edition of the DSM -IV. Currently there is the fifth edition of the DSM- 5 in the English original, which was published in May 2013.

The content of the DSM is determined by experts to make diagnoses reproducible. The classification was created to facilitate the diagnosis and cure, so the nomenclature is used in hospitals and insurance companies today.

Reference to the system ICD -10

The DSM -IV is a replacement and / or a supplement for the respective passages in the ICD-10.

The ICD -10 is an international classification system of the World Health Organization of the United Nations. The DSM-IV is a national classification system of the United States of America. It therefore does not need the numerous trade-offs and additions to the ICD -10 into account and includes more specific and accurate diagnostic criteria. That makes it very interesting for research. The ICD -10, however, puts its emphasis on intensive cross-cultural perspective and the applicability especially in the countries of the Third World.

DSM -IV takes into account gender differences in contrast to the ICD-10. It does not award its own classification key, but one of the APA selected subset of those numbers which valid in 1979-1997 ICD -9 were provided for the classification of psychiatric diseases. The ICD -10 classification has different key, which complicates the comparison.


1840 a ​​category for idiocy / insanity was raised in the United States with a population census. Forty years later there were already seven categories of serious mental illness. After the Second World War there were soldiers who had to be treated for less severe mental disorders. So the veterans associations and the U.S. Army developed a comprehensive classification.

Finally, In 1952, the American Psychiatric Association the drafting of the DSM. They tried to tune the classification key with the then ICD 6. In 1968 the second edition of the DSM. She had little influence on psychiatric teaching, research and clinical practice. As was the famous psychoanalyst Irving Bieber asked " Have you heard the terrible news? Take homosexuality out of the future printings of DSM -II. " He replied ," What is the DSM- II? ".

It was not until the DSM -III ( 1980) required by the WHO precise definitions of mental disorders were taken into account. The third issue presented here is an incision in the previous classification, partly due to the multiaxial classification (see below ) and the most extensive detachment of etiology and theory related terminology. Klerman called the DSM- III as a " paradigm shift ". The version created under the direction of Robert L. Spitzer was the first widely adopted. In 1987 he was a revision of this edition (DSM- III -R) and in 1994 the DSM -IV under the direction of Allen Frances. The text revision of the fourth edition (DSM -IV -TR) was published in 2000.

1984 was the DSM- III in German before publication, in 1989, the DSM- III -R; since 1996, the DSM -IV; only two years after the American version. The German translation of the DSM -IV -TR was published in 2003.

The DSM -5 was in labor since 1999 and was released in May 2013. Darrel A. Regier from 2000, recorded as research director of the APA responsible for coordinating the preparatory work, since 2004, has its own website. Since 2006, a Task Force under the direction of David J. Copper, Darrel A. Regier acts as deputy. Since 2007, working groups meet regularly to the different diagnostic categories. In addition, the research results of numerous conferences and congresses are incorporated.

Multiaxial classification

The DSM is currently in Germany only in the fourth version ( DSM -IV -TR, 2000), systematic psychiatric diagnoses since the third version (DSM -III, 1980) in five axes. To a diagnostic indication of the state belongs to each of these five axes:

  • Axis I: Clinical disorders and other clinically relevant problems. Mainly state disorders, severe mental disorder and faulty learning disabilities (examples: schizophrenia, anxiety disorders, impulse control disorders, eating disorders ).
  • Axis II: Personality disorders (examples: borderline personality disorder, schizoid or paranoid personality disorder, antisocial personality disorder) and mental disabilities.
  • Axis III: Medical illness factors. This priority has physical problems that may be relevant to the Mental disorder significant.
  • Axis IV: Psychosocial and environmental related problems (examples: housing problems, vocational problems, problems in the social environment )
  • Axis V: Global assessment of functioning level based on the GAF scale.

On some of these axes, the specification can also be " none" or a multiple.


Overall, the DSM for the axes I and II 16 diagnostic categories:


There is criticism that the DSM -IV is unscientific and symptom-oriented, having reductionist error. Similarly, criticism is that all the authors of the DSM -IV would get money from the pharmaceutical industry, while DSM-IV diagnoses conditions for many U.S. insurance companies had to pay for medicines for patients.

The Internet presence of the DSM - V Prelude Project writes about shortcomings of the DSM -IV and the improvements for the DSM- V to be ( at that time still with Roman numbering) discussed and researched.