ABSTRACT
Modern-day psychiatric diagnosis can trace its roots back to Hippocrates, who identifi ed personality types based on the composition of the bodily humors (i.e., fl uids). Obviously, the fi eld has evolved quite a ways from its very earliest nomenclature, yet it remains the case that the major objective throughout the evolution of psychiatric diagnosis has been to create the most accurate description of a complex collection of cognitive, emotional, social, motivational, and behavioral symptoms that characterize a psychiatric disorder. Early eff orts to do this were presented by Kretschmer (1925) and Kraepelin (1921), as were later notable taxonomies reported by Fenichel (1945), Laughlin (1956), Schneider (1958), Shapiro (1965), and Kernberg (1970). Notable was the infl uence of psychoanalytic theory on the development of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) system. However, as the DSM system evolved, there was increasing pressure to move away from its psychoanalytic origins to a more “atheoretical” system. Th is was precisely the intention when the DSM, 3rd ed. (DSM-III) (American Psychiatric Association, 1980) was published. A multiaxial system of diagnosis was off ered, and psychiatric disorders were to be placed on either Axis I or II. Th e former was for clinical syndromes and problems, most of which were acute in nature, whereas the latter was reserved for personality disorders and mental retardation. However, many were unhappy with this change.
