Over the past seventy years, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, has evolved from a virtually unknown and little-used pamphlet to an imposing and comprehensive compendium of mental disorder. Its nearly 300 conditions have become the touchstones for the diagnoses that patients receive, students are taught, researchers study, insurers reimburse, and drug companies promote. Although the manual is portrayed as an authoritative corpus of psychiatric knowledge, it is a product of intense political conflicts, dissension, and factionalism. The manual results from struggles among psychiatric researchers and clinicians, different mental health professions, and a variety of patient, familial, feminist, gay, and veterans' interest groups. The DSM is fundamentally a social document that both reflects and shapes the professional, economic, and cultural forces associated with its use.
In DSM, Allan V. Horwitz examines how the manual, known colloquially as "psychiatry's bible," has been at the center of thinking about mental health in the United States since its original publication in 1952. The first book to examine its entire history, this volume draws on both archival sources and the literature on modern psychiatry to show how the history of the DSM is more a story of the growing social importance of psychiatric diagnoses than of increasing knowledge about the nature of mental disorder. Despite attempts to replace it, Horwitz argues that the DSM persists because its diagnostic entities are closely intertwined with too many interests that benefit from them.
"Allan Horwitz—the recognized authority on the DSM—is both balanced and fair minded. There is nothing else like this book."
— Elizabeth Lunbeck, Harvard University, author of The Americanization of Narcissism
"DSM: A History of Psychiatry's Bible is the first comprehensive account of American psychiatry's growing obsession with diagnosis, and the massive flaws that have undermined this project. Horwitz's book is a remarkable achievement, a richly detailed account of the blind alley psychiatrists have wandered down and of the crisis that now confronts the profession."
— Andrew Scull, University of California-San Diego, author of Madness in Civilization: A Cultural History of Insanity from the Bible to Freud
"In this ironically-titled book, Horwitz, one of the leading social scientists of psychiatry, recounts how the DSM has led psychiatry not into a promised land but a wasteland. Horwitz tells this dramatic, epochal story at a good clip, on the basis of original research, and with a firm understanding that it is a story about society, not about 'medicine.'"
— Edward Shorter, University of Toronto, coauthor of The Madness of Fear: A History of Catatonia
"Meticulous and incisive, this book charts the standardization of American psychiatric diagnoses since 1952. It details how a thin, spiral-bound volume first known as Medical 203 grew into a massive tome currently diagnosing 541 psychiatric conditions and selling millions of copies worldwide. For Horwitz, an excellent guide to its many quirks and revisions, 'the constantly changing nature of the DSM is its most interesting feature.'"
— Christopher Lane, Northwestern University, author of Shyness: How Normal Behavior Became a Sickness
About the Author:
Allan V. Horwitz is a professor of sociology in the Department of Sociology and Institute for Health, Health Care Policy, and Aging Research at Rutgers University. He is author of Creating Mental Illness.