ABSTRACT
Psychiatry has long been plagued by a stubborn, inconvenient fact: the knowledge regarding the nature of mental distress remains elusive. For the past four decades, nosological reforms have been the primary means by which American psychiatrists have staved off the effects of their ignorance and propped up their professional authority. Central to these efforts have been revisions to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a nosological manual that defines the criteria for every recognised mental disorder by the American Psychiatric Association (APA). The first two editions, DSM-I (American Psychiatric Association 1952) and DSM-II (American Psychiatric Association 1968), were considered marginal documents, largely ignored by clinicians and used primarily to serve various bureaucratic imperatives. The major concern driving the DSM-III revision was the reliability of diagnoses, the extent to which diagnostic criteria would yield agreement among clinicians.
