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July 7, 1993

Psychiatrists Set to Approve DSM-IV

JAMA. 1993;270(1):13-15. doi:10.1001/jama.1993.03510010015003

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A NEW diagnostic manual slated for final approval this week marks perhaps the most rigorous attempt yet to base psychiatric practice on hard science.

Soft science and even what critics say is non-science have plagued psychiatry ever since Sigmund Freud first asserted that women who reported being sexually abused were merely suffering from "penis envy."

"More than any other nomenclature of mental disorders, DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) is grounded in empirical evidence," says Allen J. Frances, MD, chair, Department of Psychiatry, Duke University Medical Center, Durham, NC.

Frances chairs the American Psychiatric Association's 27-member task force that has worked with some 1000 advisers over 5 years, conducting 150 reviews of the scientific literature, 50 data reanalyses with funding from the John D. and Catherine T. MacArthur Foundation (Chicago, Ill), and 12 field trials to evaluate diagnostic criteria.

Those trials, funded by the National Institute