Abstract
This paper reviews the history of the development of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) using the diagnostic category of delirium as an example. It also attempts to show how clinical practice and experience has molded the current conceptualization of delirium in DSM-IV. The paper presents the process and options the DSM-IV Work Group on Organic Disorders pursued in developing the DSM-IV criteria for the diagnosis of delirium, particularly in relation to ICD-10.

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