The dust-up over DSM-V, the upcoming diagnostic bible for shrinks.

Psychiatrists are having one of their periodic dust-ups over the question of diagnosis. The back-and-forth has to do with the development, by the American Psychiatric Association, of a new diagnostic bible, DSM-V, the manual that will determine how mental health professionals in this country divide wellness from disorder and, in the disorder category, one condition from another. The updating is always controversial. Outright opponents of psychiatry find any change suspect: How is it that a person might be judged ill in one era and healthy in another?

In this case, the critics, Allen Frances and Robert Spitzer, are psychiatrists who have been responsible for just that sort of shift. They led, respectively, the task forces that developed the two prior diagnostic and statistical manuals, DSM-IV and DSM-III. In effect, the old guard says that the new undertaking is too secretive—scholars reshaping the DSM categories have signed nondisclosure commitments, a highly unusual step in the academic world, where the science of diagnosis resides. The critics also claim that the time is not ripe, that research results do not yet justify the adoption of a new framework for classifying mental illnesses.