The DSM IV is a big book listing all the ways you can be crazy, and how to recognise them. Psychiatrists, psychologists and the like use it for diagnosis. I don't remember what DSM stands for (something with Diagnosis and Manual, I think) but the IV reflects the fact that it's the fourth major revision. Sometimes they downgrade something, because they've decided it's not actually a mental illness, it's just a personality trait or something (this happened with passive-aggressive behaviour, which was considered loony when it was first described, rather than merely annoying as shit), and sometimes they add something new that's been identified, like if someone invents a new sort of madness, and they refine the existing definitions based on more recent research, to make them more accurate and helpful. There is a LOT of debate among psych professionals about what should be in the book, how it should be described and defined, how to distinguish between disorders with very similar symptoms, whether something is real or the crazy people are totally faking, whether the Joker counts, etcetera, etcetera, and it keeps them very busy with papers and abstracts of research and letters to editors in between the official revisions.
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