Here are the official number of ways you can go nuts, according to the peer-reviewed Diagnostic and Statistical Manual of Mental Disorders.
The DSM-I started in 1952 with just 601 ways that your mind could go awry. A committee of folks from the World Health Organization, the US Army, and other psychiatric professionals gathered together, pooled their experience, and decided that these 60—and only these 60—diagnoses meant you were mentally ill.
By 1968, these experts changed their minds. They announced, “The Science was not settled” but implied that it now was when they published DSM-II, discovering three times as many more ways to end up under care, putting the total at 182.
After their yearly convention was stormed by angry homosexual activists in 1974, the committee changed their minds and dropped one major diagnosis, leaving just 181 in DSM-II (amended) . Before 1974, medical professionals assured us that “ego-dystonic homosexuality” was a (treatable) disorder. From 1974, it was reclassified as a “sexual orientation disturbance.”
Just six short years later, in 1980 the medical community again admitted they were wrong before and said now that there were 265 mental maladies, and not a mere 181 as previously thought. These went into the DSM-III.
“Not so!” said the reconstituted DSM-III-R committee of 1987, “There are 292 misconfigurations of the mind. We’re not sure how those who came before us could have missed so many diseases.” This was mostly okay with the folks who met again in 1994 to put out DSM-IV: they only added a bare five newly discovered disorders.
The last committee met in 2000 and were either not imaginative enough to figure any new disorders. They could only bring themselves to reclassify and reword. But they felt that had enough authorial input to rename the book to the DSM-IV-TR
Now, the DSM-V is scheduled to be released in 2013. Given the increase we have seen from previous editions, it is rational to suppose that the latest work will detail many new diseases previously unknown to medical science. How many more?
The bottom dashed line is a crude statistical extrapolation. The upper dashed line uses information from Tim Black’s Spiked paper “Are you shy? Then you have a mental disorder.”
Wikipedia counts 297 diseases in DSM-IV, but Black asserts that by 1994 there were already “384 mental ailments (plus 28 ‘floating diagnoses’).” That’s a huge discrepancy, likely the result of counting sub-diagnoses separately. But if he’s right, then we can guess that there will be at least 384 entries in 2013.
About the increases, Lisa Appignanesi of the Guardian isn’t happy about this:
Over the last 40 years The Diagnostic and Statistical Manual of Mental Disorders – the bible of the psychiatric professions – has spawned more and more diagnostic categories, “inventing” disorders along the way and radically reducing the range of what can be construed as normal or sane. Meanwhile Big Pharma, feeding its appetite for profits and ours for drugs, has gained an ever greater hold over our mental and emotional lives, medicalising normality.
Black concurs and gives us an example of the newly discovered “hoarding disorder”:
In an incredible bit of insightless prose, we are told by DSM‘s recent consultation document that, ‘The symptoms [of hoarding disorder] result in the accumulation of a large number of possessions that fill up and clutter active living areas of the home or workplace to the extent that their intended use is no longer possible’.
The numbers are also unclear because the DMS-V has been wrapped in secrecy: task force members were made to sign a nondisclosure agreement which forbade them to speak about the process. In a bit of unintentional hilarity, Robert Spitzer, the head of the DSM-III task force, said
When I first heard about this agreement, I just went bonkers. Transparency is necessary if the document is to have credibility, and, in time, you’re going to have people complaining all over the place that they didn’t have the opportunity to challenge anything.
I propose that Spitzer’s outburst be classified as dissonant peer-review neurosis. Other entries are welcomed.
1As of 12 September 9:00 AM PST, this post is tentative. I am using data sources which give contradictory information, and so I ask you, my loyal readers, for help in firming up the numbers, at which point I will update the picture. My numbers were retrieved from Wikipedia (yes, I know).
This post is a follow-up to “Are 40 Percent of Europeans Mentally Ill?”