The Diagnostic and Statistical Manual of Mental Disorders is part medical guidebook, part legal reference. The manual is used:

• By insurers: It dictates whether insurers will pay for treatment

• By schools: They use it to determine financing decisions for certain special-education services.

• By pharmaceuticals to guide their research

• By courts: It helps them assess whether a criminal defendant is mentally impaired

what are the Proposed changes?

• The American Psychiatric Association is proposing that the manual expand the list of recognized symptoms for drug and alcohol addiction and reduce the number of symptoms required for a diagnosis.

• The changes also would for the first time include gambling as an addiction, and it might introduce a catchall category -- "behavioral addiction -- not otherwise specified" -- that some experts warn would be too readily used by doctors.