Insiders know it is more a political than scientific document. To its credit it says so, although its brief apologia is rarely noted. DSM IV has become a bible and a money making best seller - its major failings notwithstanding. It confines and defines practice, some take it seriously, others more realistically. It is the way to get paid.
Diagnostic reliability is easy to attain for research projects.
They don't, and can't, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder. To begin with, let us be ourselves. Stop taking on unholy alliances without the members' permission. Label each for what it is - that is, be honest.