When researchers announced that 16 million Americans who fly into occasional fits of unwarranted rage may suffer from a mental illness called "intermittent explosive disorder," the diagnosis drew its share of hoots and howls.
"Your grandmother would say these are bad folks who can't control their temper, and she would be right," said Dr. E. Fuller Torrey, an outspoken schizophrenia expert alarmed by the ever-expanding list of behaviors and attitudes branded as illnesses.
Torrey and other critics point to the volume that doctors use to determine mental illness, the Diagnostic and Statistical Manual of Mental Disorders, as evidence that the world is out of control.
When it was first published in 1952, the DSM identified about 100 official mental disorders. Today, it certifies roughly 375.
Intermittent explosive disorder became the latest of those to reach the public consciousness in June, when a study of the syndrome, funded by the National Institutes of Health, was released.
Newspaper columnists and others around the country exploded in skepticism at its conclusions.
"Is it me, or does it seem like good old-fashioned bad behavior - rudeness, obsession, violence - is being increasingly explained away by doctors and pharmaceutical companies as some kind of mental illness du jour?" asked columnist Daniel Vasquez in the South Florida Sun-Sentinel.
In Georgia, a headline in The Augusta Chronicle read, "Jerks get disorder of their own."
While many critics echoed the derision historically reserved for mental illness, some mental health experts - including Torrey - are also skeptical.
"It's not a well-defined entity," Torrey said of IED. At the heart of his concern is a question mental health providers have long debated: When does a behavior or emotion cross the line from normal - however eccentric or undesirable - to become an illness?
What they decide affects many aspects of American life, ranging from criminal trials to decisions on who gets treatment and disability benefits for mental illness.
The most visible venue for that debate is the DSM, the primary reference for mental health professionals. When the American Psychiatric Association revises the manual every few years, doctors have to decide what disorders will be included.
Although the DSM's definitions of mental disorders are only guidelines, they influence courts, insurance companies and government agencies.
