The APA's fifth edition of the Diagnostic and Statistical Manual (DSM-V), scheduled to appear in two years, is entertaining public comments through June 15. It is now being field tested to see how well the revisions work in actual clinical practice before it becomes the new canon.

The process of redefining criteria for diagnosis is fraught with implications for diagnostic purity, insurance reimbursement, the promotion of drugs, eligibility for disability entitlements, and compatibility with international standards.

A revision of the official manual of psychiatric disorders is often accompanied by controversy and professional disagreements based on research as well as clinical observations.The blog, 1 Boring Old Man, written by a retired psychiatrist who threads personal experience through otherwise opaque processes, lends insight to tensions that occupied early efforts to arrive at a shared language for observable behavior.

Some are particularly relevant today. Revision of the DSM-V has seen more disputes reaching the public than might have been the case before. Editors of earlier editions have been openly critical of the lack of transparency of the boards and content is also subject to debate. Whether to elevate behaviors that were once considered a symptom, such as binge eating, to its own diagnostic category, or to upgrade a diagnosis, Borderline Personality Disorder, from one platform of severity to another, can have lasting consequences. . .until the next revision.