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December 28, 1994

The Medical Basis of Psychiatry

JAMA. 1994;272(24):1954-1955. doi:10.1001/jama.1994.03520240082049

During the eight years between the first and second editions, much has transpired in the field of psychiatry. The Diagnostic and Statistical Manual of Mental Disorders has evolved from the third edition (DSM-III) through a revision in 1987 (DSM-III-R) to the 1994 fourth edition (DSM-IV). The selective serotonin reuptake inhibitors have become first-line antidepressants. Serotonin uptake inhibitors (including clomipramine) have been a boon to those with obsessive-compulsive disorder (a condition described as "rare in the general population" in DSM-III but more recently recognized to have a one-year prevalence of 1.5% to 2.1%). Clozapine has offered hope in otherwise treatmentresistant schizophrenia. Enormous strides have been made in neurobiology, neuropharmacology, and neuroimaging. Specific psychotherapies (behavioral, cognitive, interpersonal) have withstood the rigors of carefully conducted research and are becoming more widely disseminated treatments.

The editors are cognizant of these recent advances and planned to incorporate them into the second edition, writing, "It is

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