Cheryl Fuller on the next edition of the DSM:
Especially when there is consideration of adding bitterness, sub-clinical bipolar disorder and other variations of what many, including me, consider to be within the range of normal experience and behavior. And I cannot believe that there is real research evidence to establish these or many of the existing diagnostic categories as anything other than descriptions of clusters of behavior. Because all of the diagnostic categories rely on observer report, not tests or other diagnostic tools, because they simply do not exist. What we have now are lists of symptoms or behaviors -- display 6 out of 10, for example, and you fit the category; 5 and you don't. But that makes no sense. What is the difference between the two such that having slightly more symptoms means you are mentally ill -- and that term is an argument for another day -- and thus appropriate for treatment?
I know they're out there, but I don't personally know any clinicians who believe that the DSM serves any worthwhile clinical purpose. It's a convenience for the insurance industry.