Am J Psychiatry 1991; 148:421-431
Copyright © 1991 by American Psychiatric Association
Origins of DSM-I: a study in appearance and reality
GN Grob
Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ 08903.
The author traces the history of psychiatric nosology in the United States
from its origins in the early nineteenth century to the introduction of
DSM-I in 1952. Until World War I, psychiatrists were not interested in
systematic classification, although they were concerned with diagnosis. The
first official nosology, adopted in 1918, reflected the need to collect
mental hospital data. The federal Bureau of the Census had a role in the
development of this nosology in that it required such data. The publication
of DSM-I marked an internal transformation that mirrored the growing
dominance of psychodynamic and psychoanalytic psychiatry and the relative
weakness of the biological tradition. This transformation occurred largely
as a result of the lessons learned by psychiatrists during World War II.
The author's basic argument is that nosology reflected not only psychiatric
ideology but also other, external determinants at any given point in time.
