University of Arkansas, Fayetteville


This paper traces the history of psychiatric nosology in the US from its origins in the early 19th century through the most recent revision of the standardized classification, DSM-IV TR. The evolution of nosology is found to be shaped not only by advances in knowledge, but also by socio-historic and professional trends. The initial impetus for systematic classification came from outside the mental health profession, but later revisions reflected intraprofessional struggles and experiences. Future revisions will almost certainly be prone to these same intra- and extraprofessional influences, and may see a dramatic shift away from symptomatology and towards an etiological focus.