DSM-Reason and Its Discontent

Abstract

We analyze the paradigm of American psychiatry after the third edition of the diagnostic manual by the American Psychiatric Association published in 1980 (DSM-III), as “DSM-reason,” and summarize its history to its fifth edition (DSM-5) in 2013. In particular, by tracing the contestation over the diagnosis of psychiatric disorders, we clarify what kind of conditions are relevant for generating contestation in the making/revision process of DSM. Results suggest that the contestations are partly produced by the following characteristics of DSM-reason; the majority-vote procedure in deciding diagnostic criteria, the involvement of diverse actors other than the psychiatric community who might be driven identity recognition and/or economic interest, the operational definition of psychiatric disorders which blurs the distinction between the normal and disease, and the DSM-reason’s difference from the standard biomedical model. Medicine is not an independent unified entity, but is susceptible to and dependent on diverse social power relations.