A few days ago I put together a sketchy summary describing the evolution of the Diagnostic and Statistical Manual of Mental Disorders (DSM) over the last 100 years or so. In doing so, the idea that the DSM schema as in any other purpose-build manual represents the social constructs and states of distress that have local biopsychosocial sources of the day becomes plainly obvious.
If for example the DSM, amongst other things, is so organized such that it legitimatises remuneration to practitioners from private medical insurance and government programs – which it does, then that particular social use may be immaterial in countries and societies where health care is financed differently.
This is illustrated in the Chinese Classification of Mental Disorders (CCMD) system which includes diagnostic categories which are more specific to Chinese or Asian culture such as Koro, an excessive fear of the genitals and women’s breasts shrinking or drawing back in to the body. Another, Zou huo ru mo the perception of uncontrolled flow of qi in the body. The DSM’s diagnosis of borderline personality disorder becomes impulsive personality disorder in the CCMD-3.
Local applications aside, it is a testament to the global flow of information technology and China’s more preparedness for openness that the CCDM-3 is marked with greater global unification and international usage of diagnosis and coding.