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The Impact of DSM-III on Diagnostic Practice in a University Hospital: A Comparison of DSM-II and DSM-III in 10 914 Patients

The Impact of DSM-III on Diagnostic Practice in a University Hospital: A Comparison of DSM-II and... Abstract • The DSM-III is the first criteria-based, multiaxial classification system of mental disorders. Since its introduction in 1980, it has received more attention than any previous nosology in the history of psychiatry. The present report attempts to gauge the impact of DSM-III on diagnostic practice at one of the largest university-affiliated psychiatric hospitals in the United States. It compares the diagnoses given to 10 914 hospitalized patients during the last 5 years of the DSM-II era and the first 5 years of the DSM-III era. There were two major consequences of the change from DSM-II to DSM-III: (1) a marked reduction in the diagnosis of schizophrenia and a corresponding increase in the diagnosis of affective disorders, and (2) a marked increase in the diagnosis of personality disorders. References 1. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 2. Kramer M. Some problems for international research suggested by observations on differences in first admission rates to the mental hospitals of England and Wales and of the United States . In: Panel Discussions of The Third World Congress of Psychiatry, III . Montreal, Canada: Toronto University Press; 1963:153-160. 3. Sandifer MG, Hordern A, Timbury GC, Green LM. Psychiatric diagnosis: a comparative study in North Carolina, London, and Glasgow . Br J Psychiatry . 1968;114:1-9.Crossref 4. Katz M, Cole J, Lowery HA. Studies of the diagnostic process: the influence of symptom perception, past experience and ethnic background on diagnostic decisions . Am J Psychiatry . 1969;125:937-947. 5. Kendell RE, Cooper JE, Gourlay AJ, Copeland JRM, Sharpe L, Gurland BJ. Diagnostic criteria of American and British psychiatrists . Arch Gen Psychiatry . 1971;25:123-130.Crossref 6. Blashfield RK. Feighner et al., invisible colleges, and the Matthew Effect . Schizophr Bull . 1982;8:1-6.Crossref 7. Loranger AW, Susman VL, Oldham JM, Russakoff LM. The Personality Disorder Examination: a preliminary report . J Pers Dis . 1987;1:1-13.Crossref 8. Stangl D, Pfohl B, Zimmerman M, Bowers W, Corenthal R. A structured interview for the DSM-III personality disorders: a preliminary report . Arch Gen Psychiatry . 1985;42:591-596.Crossref 9. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Second Edition . Washington, DC: American Psychiatric Association; 1968. 10. Menninger K. The Vital Balance . New York, NY: Viking Press; 1963. 11. Jaspers K. General Psychopathology . Chicago, Ill: University of Chicago Press; 1963:564-573. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

The Impact of DSM-III on Diagnostic Practice in a University Hospital: A Comparison of DSM-II and DSM-III in 10 914 Patients

Archives of General Psychiatry , Volume 47 (7) – Jul 1, 1990

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1990.01810190072010
Publisher site
See Article on Publisher Site

Abstract

Abstract • The DSM-III is the first criteria-based, multiaxial classification system of mental disorders. Since its introduction in 1980, it has received more attention than any previous nosology in the history of psychiatry. The present report attempts to gauge the impact of DSM-III on diagnostic practice at one of the largest university-affiliated psychiatric hospitals in the United States. It compares the diagnoses given to 10 914 hospitalized patients during the last 5 years of the DSM-II era and the first 5 years of the DSM-III era. There were two major consequences of the change from DSM-II to DSM-III: (1) a marked reduction in the diagnosis of schizophrenia and a corresponding increase in the diagnosis of affective disorders, and (2) a marked increase in the diagnosis of personality disorders. References 1. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 2. Kramer M. Some problems for international research suggested by observations on differences in first admission rates to the mental hospitals of England and Wales and of the United States . In: Panel Discussions of The Third World Congress of Psychiatry, III . Montreal, Canada: Toronto University Press; 1963:153-160. 3. Sandifer MG, Hordern A, Timbury GC, Green LM. Psychiatric diagnosis: a comparative study in North Carolina, London, and Glasgow . Br J Psychiatry . 1968;114:1-9.Crossref 4. Katz M, Cole J, Lowery HA. Studies of the diagnostic process: the influence of symptom perception, past experience and ethnic background on diagnostic decisions . Am J Psychiatry . 1969;125:937-947. 5. Kendell RE, Cooper JE, Gourlay AJ, Copeland JRM, Sharpe L, Gurland BJ. Diagnostic criteria of American and British psychiatrists . Arch Gen Psychiatry . 1971;25:123-130.Crossref 6. Blashfield RK. Feighner et al., invisible colleges, and the Matthew Effect . Schizophr Bull . 1982;8:1-6.Crossref 7. Loranger AW, Susman VL, Oldham JM, Russakoff LM. The Personality Disorder Examination: a preliminary report . J Pers Dis . 1987;1:1-13.Crossref 8. Stangl D, Pfohl B, Zimmerman M, Bowers W, Corenthal R. A structured interview for the DSM-III personality disorders: a preliminary report . Arch Gen Psychiatry . 1985;42:591-596.Crossref 9. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Second Edition . Washington, DC: American Psychiatric Association; 1968. 10. Menninger K. The Vital Balance . New York, NY: Viking Press; 1963. 11. Jaspers K. General Psychopathology . Chicago, Ill: University of Chicago Press; 1963:564-573.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jul 1, 1990

References