Although numbers vary depending on one's criteria, at last count the DSM (IV) contains 410 diagnoses, a 530% increase since inception. The DSM was first published in 1952 and contained 60 diagnoses. Its first revision DSM-II was published 16 years later in 1968 and contained 145 diagnoses, more than double the original. (The 60s was a mentally trying time...) DSM-III was published in 1980 and bumped up diagnoses to 231. Its major revision DSM-IIIR added 10 disorders per year for 8 years, and finally we arrive at the present incarnation, DSM-IV, published in 1994 and containing 410 disorders. Obviously psychiatry is a growth industry. And yet 1994 is, psychologically-speaking, a distant memory. Extrapolating from past publications, we must now have 595 disorders to speak of and treat. By publication date 2007, we will have to add 190 on top of this increase. When will all this madness stop!

Obviously such extrapolations, like those from the Congressional Budget Office, are apt to reflect anything BUT reality the further into the future one projects. Still that doesn't stop the government so it shouldn't stop me.

Future historians may study DSMs for sociological perspective, as ideological statements by the psychiatric community of the time, and they will have to explain why we reach quadruple digits (1,000) in 2013. Were we half as sick in 2006 and 16 times sicker than a century ago? By year 2064 we attain quintuple digits -- 10,000 conditions -- which is about one condition per psychiatrist alive today. By year 2114, ten times more; by 2165, one million disorders, and by year 2370 and using UN moderate population projections, the DSM-XXIII will contain 11 billion disorders, one per planet inhabitant. Imagine the conversations at psychiatric conferences (which will engulf entire counties and account for 70 % of GDP): "What condition did you treat him for?" "Oh, a bad case of John Jacobs." "Never heard of it." "You should, he lives on your street."

(The nonsense is almost over...) Unfortunately if one can extrapolate into the future, the past is also vulnerable. According to DSM trends, in year 1900 Sigmund Freud, at the pinnacle of his career, only had a mere six mental health conditions to deal with. How difficult is that? But more disturbing is the final extrapolation: the very first mental health condition struck the world's population sometime in 1856. The year of Freud's birth.

Coincidence or not?