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title: Redefining Mental Illness
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* [Health](/section/health/)

# Redefining Mental Illness

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by 

[John Cloud](https://time.com/author/john-cloud/)

Dec 17, 2012 5:00 AM UTC

by 

[John Cloud](https://time.com/author/john-cloud/)

Dec 17, 2012 5:00 AM UTC

In the world of mental health, the Diagnostic and Statistical Manual of Mental Disorders is more or less the bible. Doctors use the DSM’s definitions to diagnose depression, stuttering, fetishism, schizophrenia and more than 300 other conditions. Insurance companies use it to justify reimbursements; without a DSM code, mental-health patients usually don’t get a dime. And the manual carries enormous cultural heft: when it stopped listing homosexuality as a mental disorder–after a 1974 psychiatrists’ debate in which being gay was deemed sane by a vote of 5,854 to 3,810–gay rights received a crucial boost.

So naturally, on Dec. 1, when the American Psychiatric Association’s board of trustees approved a fifth edition of the DSM–which took 13 years and 1,500 mental-health experts to complete–it rocked the medical world. By trying to approach mental disorders less as discrete illnesses, like leukemia, and more as problems on a continuum, like hypertension, the APA worked to clarify its intellectual approach and also expand its reach. Here’s how the new classifications will affect patients.

GOOD NEWS FOR …

HOARDERS

For the first time, hoarding disorder will be included as a diagnosis, meaning those who can’t get rid of ephemera can now seek reimbursement for therapy

BINGE EATERS

The DSM has listed binge-eating disorder in an appendix for more than a decade, but now it’s an official diagnosis

THE BEREAVED

The previous DSM said those in mourning don’t necessarily qualify for depression therapy or medication. DSM-5 eliminates that exclusion

SKIN PICKERS

Psychiatrists have long debated whether excoriation, or skin picking, should be considered a mental illness; in DSM-5, it’s now official

MIXED NEWS FOR …

AUTISTICS

Although it reclassifies autistic disorder as autism spectrum disorder, which includes Asperger’s, the DSM-5 definition doesn’t really help improve doctors’ understanding of autism

SEX ADDICTS

DSM researchers rejected the idea that hypersexual behavior is a mental disorder, which means it will be tough for those with extreme sexual urges to seek treatment

BAD NEWS FOR …

DIVORCED PARENTS WITH DIFFICULT KIDS

Years were spent debating a proposed diagnosis called parental alienation syndrome–the difficulty kids feel after parents divorce. Despite much outrage, the DSM-5 does not include it

Sources: American Psychiatric Association; Mayo Clinic; University of Washington

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