The secret history of ICD and the hidden future of DSM

Abstract

This chapter describes a key, but largely forgotten, episode in the early development of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM) as descriptive (symptom-based) classifications of mental disorders. The received history has been that ICD-8 and its associated glossary, as the first firmly symptom-based classification, was based on a report to the WHO in the early 1960s by the British psychiatrist, Erwin Stengel, which was in turn based on a Logical Empiricist analysis of psychiatric classification developed by the American philosopher of science, Carl Hempel. Direct examination of the papers from this period, however, shows that although Hempel and Stengel were indeed highly influential, we owe the key move from earlier theoretical (aetiological) to descriptive (symptom-based) classifications to the British psychiatrist, Sir Aubrey Lewis. The final part of the chapter outlines the significance of this ‘secret history’ for the future of psychiatric classification as the basis of neuroscientific developments in psychiatric science.

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