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...Common mental conditions, such as anxiety disorders, eating disorders and depression, can be thought of as a pathological rind wrapped around an intact core. Peel the skin away through talk therapy or melt it away with drugs, and the problem may abate. Personality disorders, by contrast, are marbleized through the entire temperament. Narcissists may be self-absorbed, but they believe they jolly well have a right to be. Histrionic personalities may make too much of things, but how else can they be heard? It's hard enough to persuade most people to see a therapist--harder still when the patient...

Author: /time Magazine | Title: Masters of Denial | 1/20/2003 | See Source »

...than ever to push. As families increasingly fragment and as societal pressures grow, experts say they are seeing more cases of personality disorder than ever. As much as 9% of the population is thought to suffer from some kind of personality disorder, and as many as 20% of all mental-health hospitalizations may be the result of such conditions. Epidemiologists have not done a very good job of comparing these figures with those of earlier years, but many doctors report--anecdotally--that their PD caseload is indeed on the rise. "The more severe ones are increasing," says Josephs, "especially among...

Author: /time Magazine | Title: Masters of Denial | 1/20/2003 | See Source »

...answer that--we really don't want to know--and you should probably think twice before telling your therapist. She might diagnose you with fetishism, which is listed along with schizophrenia and bipolar disorder in a curious but extremely influential book called the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short...

Author: /time Magazine | Title: Diagnostics: How We Get Labeled | 1/20/2003 | See Source »

...lists the criteria used by mental-health professionals to make their various diagnoses, from "mild mental retardation" (the first listing) to "personality disorder not otherwise specified" (the last); there are more than 350 in all. Hence this 943-page doorstop is one of the most important books you've never heard of. And the inscrutable process of writing it is starting up again. The American Psychiatric Association (A.P.A.), the manual's publisher, recently began planning a giant review of the book. The new edition, the fifth--called DSM V--will appear around 2010. Evidently, it takes a long time...

Author: /time Magazine | Title: Diagnostics: How We Get Labeled | 1/20/2003 | See Source »

...first official attempt to measure the prevalence of mental illness in the U.S. came in 1840, when the Census included a question on "idiocy/insanity." From that single category flowered many more disorders, but each asylum classified them differently. The DSM was first published in 1952 so that "stress reaction" would mean the same in an Arkansas hospital as it does in a Vermont...

Author: /time Magazine | Title: Diagnostics: How We Get Labeled | 1/20/2003 | See Source »

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