Is the compulsion to hoard things a mental disorder? How about the practice of eating excessively at night?
And what of Internet addiction: Should it be diagnosed and treated?
The answers will determine how Americans' mental health is assessed, diagnosed and treated.
Over the next 18 months, psychiatrists will hammer out a draft of the fifth edition of the American Psychiatric Assn.'s Diagnostic and Statistical Manual of Mental Disorders, more commonly called DSM-V.
For health insurance companies, it has become a basis for decisions on paying for care.
Over the last two decades more medications have become available to treat mental disorders, and some doctors worry that the text may be written in a way that expands the market for drug therapies.
Leaders of the APA acknowledge the controversial nature of some of their discussions and have posted recent progress reports on the association's website,
www.dsm5.org