This episode was originally broadcast in 2013.

Major funding for backstory is provided by an anonymous donor,

the National Endowment for the Humanities, and the Joseph and Robert Cornell Memorial Foundation.

From Virginia Humanities, this is backstory.

Today on backstory, we're replaying an episode we put together when the DSM-5 was released.

It explores the ways past generations of Americans have drawn the line between mental health and mental illness.

It's often argued that a diagnosis can be limited by language.

That the very words used to describe an illness can determine who is seen to have that illness,

and this can have very real implications for those people diagnosed.

In his book, the Protests Psychosis, psychiatrist and sociologist Jonathan Metzel looked at the new definition for schizophrenia that emerged in the 1968 version of the DSM.

He discovered that it led to one particular demographic being disproportionately associated with the disease.

Metzel's story begins with a man that he calls Caesar Williams, committed to Michigan's Ionia State Hospital for the criminally insane in the 1950s.

He would have a pretty stable life, and then all of a sudden out of the blue would be involved in traveling somewhere spontaneously,

spending a lot of money, money that he didn't have, and getting into particular fights.

One day, Lohan beholds at a time of great stress in his life. His wife was about to give birth to their child.

He ended up traveling to Michigan and getting somehow involved in a card game that turned kind of violent, probably because he didn't have the money,

and ended up being arrested.

When he was arrested, he was saying that he was royalty and the king and other types of things.

So he was sent first to jail, and after a prolonged period of solitary confinement where he was, I think, probably physically abused, was sent into a psychiatric hospital.

And what was his diagnosis?

He was given a diagnosis in the late 1950s of what was called psychopathic personality with psychosis.

And what I found is that a lot of men like Mr. Williams, who were admitted in the 1950s and diagnosed with psychopathic personality disorder or antisocial personality disorder,

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