The History of Psychiatric Classification:
From Ancient Egypt to Modern America
A Website composed for
the History of Psychology (PSYC 6180)
The University of
Georgia
Spring 2004
Kathryn F. Moon, M.Ed.
There are no blood
tests for Schizophrenia or Attention-Deficit/Hyperactivity
Disorder. A Disorder of Written Expression cannot be seen on an
MRI. In fact, there are no traditional medical tests that detect
any of the 365 diagnoses in the Diagnostic and Statistical Manual of
Mental
Disorders, 4th edition (DSM-IV-TR), often called the Bible of
psychiatry and psychology.
If there is
no “test,” how do you know a “mental
disorder” when you seen one? According to
pp.xxi-xxii of DSM-IV-TR (2000):
- …each
of the mental disorders is
conceptualized as a clinically significant behavioral or psychological
syndrome
or pattern that occurs in an individual and that is associated with
present distress (e.g., a painful symptom) or disability (i.e.,
impairment in one or
more important areas of functioning) or with a significantly increased
risk of
suffering death, pain, disability, or an important loss of freedom. In addition, this syndrome or pattern must
not be merely an acceptable and culturally sanctioned response to a
particular
event, for example, the death of a loved one. Whatever its
original cause, it must currently be considered a
manifestation of a behavioral, psychological, or biological dysfunction
in the individual. Neither deviant
behavior
(e.g., political, religious, or sexual) nor conflicts that are
primarily
between individual and society are mental disorders unless the deviance
or
conflict is a symptom of a dysfunction in the individual, as described
above.
If this
definition leaves you less than satisfied, or even
confused, you are not alone. In fact
psychiatric classification has had a history of controversy and
confusion…
However,
before we
consider the history of classification, we must
address one question: why is classification useful?
(from Blashfield,
1998; Scotti and Morris, 2000)
- It
establishes a nomenclature for clinicians and scientists.
- It
provides descriptive information quickly.
- It
is
predictive in that it offers information on course, prognosis, and
treatment.
- It
aids
in information retrieval due to its organization.
- It
enables clinicians to receive payment for services.
- It
serves
as a step toward a theoretical understanding of psychiatric disorders.