<P> In 1917, together with the National Commission on Mental Hygiene (now Mental Health America), the APA developed a new guide for mental hospitals called the Statistical Manual for the Use of Institutions for the Insane . This included 22 diagnoses and would be revised several times by the APA over the years . Along with the New York Academy of Medicine, the APA also provided the psychiatric nomenclature subsection of the US general medical guide, the Standard Classified Nomenclature of Disease, referred to as the Standard . </P> <P> World War II saw the large - scale involvement of US psychiatrists in the selection, processing, assessment, and treatment of soldiers . This moved the focus away from mental institutions and traditional clinical perspectives . A committee headed by psychiatrist Brigadier General William C. Menninger developed a new classification scheme called Medical 203, that was issued in 1943 as a War Department Technical Bulletin under the auspices of the Office of the Surgeon General . The foreword to the DSM - I states the US Navy had itself made some minor revisions but "the Army established a much more sweeping revision, abandoning the basic outline of the Standard and attempting to express present day concepts of mental disturbance . This nomenclature eventually was adopted by all Armed Forces", and "assorted modifications of the Armed Forces nomenclature (were) introduced into many clinics and hospitals by psychiatrists returning from military duty ." The Veterans Administration also adopted a slightly modified version of Medical 203 . </P> <P> In 1949, the World Health Organization published the sixth revision of the International Statistical Classification of Diseases (ICD), which included a section on mental disorders for the first time . The foreword to DSM - 1 states this "categorized mental disorders in rubrics similar to those of the Armed Forces nomenclature ." An APA Committee on Nomenclature and Statistics was empowered to develop a version specifically for use in the United States, to standardize the diverse and confused usage of different documents . In 1950, the APA committee undertook a review and consultation . It circulated an adaptation of Medical 203, the VA system, and the Standard's Nomenclature to approximately 10% of APA members . 46% replied, of which 93% approved, and after some further revisions (resulting in its being called DSM - I), the Diagnostic and Statistical Manual of Mental Disorders was approved in 1951 and published in 1952 . The structure and conceptual framework were the same as in Medical 203, and many passages of text were identical . The manual was 130 pages long and listed 106 mental disorders . These included several categories of "personality disturbance", generally distinguished from "neurosis" (nervousness, egodystonic). </P> <P> In 1952, the APA listed homosexuality in the DSM as a sociopathic personality disturbance . Homosexuality: A Psychoanalytic Study of Male Homosexuals, a large - scale 1962 study of homosexuality by Irving Bieber and other authors, was used to justify inclusion of the disorder as a supposed pathological hidden fear of the opposite sex caused by traumatic parent--child relationships . This view was widely influential in the medical profession . In 1956, however, the psychologist Evelyn Hooker performed a study that compared the happiness and well - adjusted nature of self - identified homosexual men with heterosexual men and found no difference . Her study stunned the medical community and made her a heroine to many gay men and lesbians, but homosexuality remained in the DSM until May 1974 . </P>

When did ptsd first appear in the dsm