The newest edition of the bible" of mental disorders ... is attracting criticism from a number of experts, both for the changes made and for the foundations of the manual. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders marks the first major revision since 1994 and comes in at almost 1,000 pages. Critics say the manual includes so many disorders and such broad definitions that it has a name for any behavior outside of a narrow norm. Shawn Rubin, the chairman of the school of clinical psychology at San Francisco's Saybrook University, said the manual has led to "the pathologizing of everyday experiences," contributing to unnecessary diagnoses and use of prescription drugs. "The debate is, do we put more and more problems to get people to come out of the closet, or are we making it so there are no normal people left?" said Stephen Hinshaw, a psychology professor at UC Berkeley and a vice chairman in the department of psychiatry at UCSF. The manual, first published more than 60 years ago, is used around the world and provides doctors in the field and patients a universal language. Insurers often provide coverage based on what diagnosis from the DSM clinicians give patients. Critics say the manual is not grounded in scientific research, instead relying on symptoms to identify disorders. They argue that a new classification system is needed. From a practical standpoint, experts say, research is a long way from identifying specific markers for mental illness, and a system that is more symptom-based is necessary at the clinical level.