ABSTRACT
In 1952, when the American Psychiatric Association (APA) published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), there were 105 distinct diagnoses. In 1980, DSM-III appeared; now the number of categories was up to 260, including such newcomers as "borderline personality disorder" and "posttraumatic stress disorder". The DSM itself has become a fantastically successful product. The effects of a dramatic expansion in DSM categories are predictable. The percentage of the US population said to be "mentally ill" has tripled since 1955, with one in four Americans now said to "suffer some kind of mental disorder within a 12-month period". Even for schizophrenia, agreed by both physicians and laypeople to be the most severe form of mental illness, the public rejects a biological approach. American psychiatrists see serious mental illnesses as incurable. Social support from families and minimal use of medication in the poorer countries were seen as a key to their higher rates of recovery.
