"Dr. Spitzer’s remaking of psychiatry began with an early interest in one of the least glamorous and, historically, most ignored corners of the field: measurement."

"In the early 1960s, the field was fighting to sustain its credibility, in large part because diagnoses varied widely from doctor to doctor. For instance, a patient told he was depressed by one doctor might be called anxious or neurotic by another. The field’s diagnostic manual, at the time a pamphlet-like document rooted in Freudian ideas, left wide latitude for the therapist’s judgment. Dr. Spitzer, a rising star at Columbia University, was himself looking for direction, increasingly frustrated with Freudian analysis. A chance meeting with a colleague working on a new edition of the manual — the Diagnostic and Statistical Manual of Mental Disorders, or the D.S.M. for short — led to a job taking notes for the committee debating revisions. There, he became fascinated with reliable means for measuring symptoms and behavior — i.e., assessment.... One of the first behaviors he scrutinized was homosexuality, which at the time was listed in the manual as a mental disorder. Dr. Spitzer, after meeting with gay advocates, began re-examining homosexuality based on whether it caused any measurable distress. The issue was extremely contentious, but in 1973, Dr. Spitzer engineered a deal by which the diagnosis was replaced by 'sexual orientation disturbance,' to describe people whose sexual orientation, gay or straight, caused them distress."

Dr. Robert L. Spitzer died last Friday at the age of 83.