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1. Shard Calculation

Query:

Response:

Calculated Shard: 126 (from laksa066)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa126.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.statnews.com/2017/09/06/donald-trump-mental-illness-diagnosis/\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.statnews.com/2017/09/06/donald-trump-mental-illness-diagnosis/\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.statnews.com\/2017\/09\/06\/donald-trump-mental-illness-diagnosis\/","crawl_time":1776736718,"first_indexed_time":1504689375,"http_code":200,"src_unparsed":"com,statnews!www,\/2017\/09\/06\/donald-trump-mental-illness-diagnosis\/ s443","src_root_hash":"14590577882674370926","history_drop_reason":null,"meta_title":"I'm an expert on diagnosing mental illness. Trump doesn’t meet the criteria","meta_descriptions":["Many people speculate on Donald Trump's alleged mental disorder. But he doesn't meet the criteria for mental illness. He's crazy like a fox."],"attrs_boilerpipe_text":"D\niagnosing President Donald Trump’s alleged mental disorder has become a popular pastime,\nnot just among mental health professionals\nbut also among politicians, journalists, pundits, comedians, and ordinary people gathered at coffee breaks. Trump’s consistently bizarre sayings and doings have \ntriggered a bill\nto establish a commission “on presidential capacity” and a suggestion that the president be removed from office\nvia the 25th Amendment\non the grounds that he is mentally unfit to be president.\nA\nrecent Time poll\nindicates that many Americans think that Trump is unfit for office. I also believe we made a terrible mistake electing him. But Trump’s disagreeable traits in no way indicate that he is mentally ill. Instead, they reveal him to be the ruthless self-promoter he has always been, now poorly cloaked in fake populist clothing.\nBefore I go any further, you should know that I am a lifelong political inactivist, shamefully missing in action from the tumultuous political events of the last 50 years. It took the travesty of a Trump presidency to get me fully engaged.\nConfusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed.\nTrump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the\nDiagnostic and Statistical Manual of Mental Disorders\n(DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way.\nMy long experience with psychiatric diagnosis has taught me a recurring and painful lesson: Anything that can be misused in the DSM will be misused, especially when there is an external, nonclinical reward for doing so. We decided to include narcissistic personality disorder in the DSM-III 40 years ago purely for clinical reasons. We never imagined it would be used as ammunition in today’s political warfare.\nIt’s also important to note that narcissistic personality disorder holds a fragile place in the diagnostic universe. It came quite close to being eliminated when the fifth edition of the DSM was published in 2013, and will be excluded from the forthcoming revision to the International Classification of Diseases, a set of codes used by physicians and other health care providers to classify diagnoses, symptoms, and procedures.\nSome presidential observers base their diagnosis of delusional disorder on Trump’s being an avid consumer and creator of conspiracy theories. He learned his art from a master:\nhis mentor, Roy Cohn\n, who was the brains behind Sen. Joseph McCarthy’s attempt to control our government through Communist witch hunts in the 1950s. Conspiracy theorists are a dime a dozen, while those with delusions are more rare. Up to\nhalf of all Americans\nbelieve in strange conspiracy theories. They are wrong, but not delusional. Having a delusion means being a minority of one.\nAlso keep in mind that Trump’s conspiracy theories have been, and continue to be, essential to his political success. His\nlong-standing claim\nthat President Obama was not born in the United States launched Trump’s presidential run, his “crooked Hillary” claims helped win him the election, and “fake news” holds his base in his thrall. Trump is\ncrazy like a fox\n.\nThe dementia diagnosis is based on the supposed poverty and perseveration in\nTrump’s current speech patterns\ncompared to his earlier ones. I would attribute this to the number of stump speeches Trump has given. Abraham Lincoln could find creative ways of repeatedly saying the same thing, but Trump has never achieved Lincoln’s eloquence. He uses the same words over and over again because they successfully work up the crowd.\nConvincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving.\nBuried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position. If this were policy, Abraham Lincoln and Winston Churchill both would have been lost to history due to their battles with depression.\nAssigning psychological disorders to Trump is not only wrong but futile. Vice President Pence, the Cabinet, and Congress would never\ninvoke the 25th Amendment\nbecause it would amount to political suicide for everyone concerned and for the Republican Party. Any psychological fitness exam would also be inherently biased and unreliable. My guess is that Trump will eventually be removed from power, but via the appropriate investigative and political process, not a psychiatric evaluation.\nI believe that Trump is a mirror of the American soul, a surface symptom of our deeper societal disease. He may not be crazy, but we certainly were for electing him. We mustn’t waste this Trumpian dark age. If we don’t learn from it, we will keep making the same mistakes.\nAllen Frances, M.D., was chair of the Department of Psychiatry and Behavioral Sciences at Duke University and also chaired the task force responsible for revising the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. He is the author of “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump” (William Morrow, September 2017).","attrs_markdown":"[Skip to Main Content](https:\/\/www.statnews.com\/2017\/09\/06\/donald-trump-mental-illness-diagnosis\/#wrapper)\n\n[research](https:\/\/www.statnews.com\/topic\/research\/)\n\n[Drug prices](https:\/\/www.statnews.com\/topic\/drug-prices\/)\n\n[Cancer](https:\/\/www.statnews.com\/topic\/cancer\/)\n\n- [Newsletters](https:\/\/www.statnews.com\/signup\/)\n- [Log In](https:\/\/www.statnews.com\/login\/)\n- [My Account](https:\/\/www.statnews.com\/my-account\/)\n- [Subscribe Now](https:\/\/www.statnews.com\/stat-plus\/)\n\nMy Account\n\n- [Settings Complete your personal information for a more tailored experience](https:\/\/www.statnews.com\/my-account\/)\n- [Billing](https:\/\/www.statnews.com\/my-account\/billing\/)\n- [Log In](https:\/\/www.statnews.com\/login\/)\n\n[![STAT](https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/stat-logo-10.svg) A decade of reporting from the frontiers of health and medicine](https:\/\/www.statnews.com\/)\n\n- [Newsletters](https:\/\/www.statnews.com\/signup\/)\n- [Log In](https:\/\/www.statnews.com\/login\/)\n- [My Account](https:\/\/www.statnews.com\/my-account\/)\n- [Subscribe Now](https:\/\/www.statnews.com\/stat-plus\/)\n\n- [Biotech](https:\/\/www.statnews.com\/category\/biotech\/)\n- [Pharma](https:\/\/www.statnews.com\/category\/pharma\/)\n- [Public Health](https:\/\/www.statnews.com\/category\/health\/)\n- [Health Tech](https:\/\/www.statnews.com\/category\/health-tech\/)\n- [Policy](https:\/\/www.statnews.com\/category\/politics\/)\n- [Science](https:\/\/www.statnews.com\/category\/in-the-lab\/)\n- [First Opinion](https:\/\/www.statnews.com\/category\/first-opinion\/)\n- [STAT+](https:\/\/www.statnews.com\/topic\/stat-plus\/)\n- [STAT Events](https:\/\/www.statnews.com\/events)\n\n[![STAT](https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/stat-logo-10.svg)](https:\/\/www.statnews.com\/)\n\n- [Log In](https:\/\/www.statnews.com\/login\/)\n- [Subscribe Now](https:\/\/www.statnews.com\/stat-plus\/)\n- [My Account](https:\/\/www.statnews.com\/my-account\/)\n\n[Home](https:\/\/www.statnews.com\/)\n\nNews\n\n- [Latest](https:\/\/www.statnews.com\/latest\/)\n- [STAT10](https:\/\/www.statnews.com\/stat-10th-anniversary\/)\n- Business\n  - 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Donald Trump doesn’t meet the criteria\n\nBy Allen FrancesSept. 6, 2017\n\n[Reprints](https:\/\/www.parsintl.com\/publications\/stat\/)\n\n![Trump](https:\/\/www.statnews.com\/wp-content\/uploads\/2017\/09\/GettyImages-837326796-645x645.jpg)\n\nNicholas Kamm\/AFP\/Getty Images\n\nDiagnosing President Donald Trump’s alleged mental disorder has become a popular pastime, [not just among mental health professionals](https:\/\/www.statnews.com\/2017\/01\/30\/trump-mental-health\/) but also among politicians, journalists, pundits, comedians, and ordinary people gathered at coffee breaks. Trump’s consistently bizarre sayings and doings have [triggered a bill](https:\/\/www.statnews.com\/2017\/08\/16\/donald-trump-mental-health-congress\/) to establish a commission “on presidential capacity” and a suggestion that the president be removed from office [via the 25th Amendment](http:\/\/www.politico.com\/story\/2017\/08\/23\/trump-california-mental-health-241915) on the grounds that he is mentally unfit to be president.\n\nA [recent Time poll](http:\/\/time.com\/4800080\/donald-trump-impeachment-poll\/) indicates that many Americans think that Trump is unfit for office. I also believe we made a terrible mistake electing him. But Trump’s disagreeable traits in no way indicate that he is mentally ill. Instead, they reveal him to be the ruthless self-promoter he has always been, now poorly cloaked in fake populist clothing.\n\nAdvertisement\n\nBefore I go any further, you should know that I am a lifelong political inactivist, shamefully missing in action from the tumultuous political events of the last 50 years. It took the travesty of a Trump presidency to get me fully engaged.\n\nConfusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed.\n\nTrump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the [Diagnostic and Statistical Manual of Mental Disorders](https:\/\/www.psychiatry.org\/psychiatrists\/practice\/dsm\/history-of-the-dsm) (DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way.\n\nAdvertisement\n\nMy long experience with psychiatric diagnosis has taught me a recurring and painful lesson: Anything that can be misused in the DSM will be misused, especially when there is an external, nonclinical reward for doing so. We decided to include narcissistic personality disorder in the DSM-III 40 years ago purely for clinical reasons. We never imagined it would be used as ammunition in today’s political warfare.\n\nIt’s also important to note that narcissistic personality disorder holds a fragile place in the diagnostic universe. It came quite close to being eliminated when the fifth edition of the DSM was published in 2013, and will be excluded from the forthcoming revision to the International Classification of Diseases, a set of codes used by physicians and other health care providers to classify diagnoses, symptoms, and procedures.\n\nSome presidential observers base their diagnosis of delusional disorder on Trump’s being an avid consumer and creator of conspiracy theories. He learned his art from a master: [his mentor, Roy Cohn](https:\/\/www.nytimes.com\/2016\/06\/21\/us\/politics\/donald-trump-roy-cohn.html?mcubz=0), who was the brains behind Sen. Joseph McCarthy’s attempt to control our government through Communist witch hunts in the 1950s. Conspiracy theorists are a dime a dozen, while those with delusions are more rare. Up to [half of all Americans](http:\/\/www.npr.org\/2014\/06\/04\/318733298\/more-americans-than-you-might-think-believe-in-conspiracy-theories) believe in strange conspiracy theories. They are wrong, but not delusional. Having a delusion means being a minority of one.\n\nAlso keep in mind that Trump’s conspiracy theories have been, and continue to be, essential to his political success. His [long-standing claim](http:\/\/www.cnn.com\/2016\/09\/09\/politics\/donald-trump-birther\/index.html) that President Obama was not born in the United States launched Trump’s presidential run, his “crooked Hillary” claims helped win him the election, and “fake news” holds his base in his thrall. Trump is [crazy like a fox](https:\/\/www.statnews.com\/2017\/01\/30\/trump-mental-health\/).\n\nThe dementia diagnosis is based on the supposed poverty and perseveration in [Trump’s current speech patterns](https:\/\/www.statnews.com\/2017\/05\/23\/donald-trump-speaking-style-interviews\/) compared to his earlier ones. I would attribute this to the number of stump speeches Trump has given. Abraham Lincoln could find creative ways of repeatedly saying the same thing, but Trump has never achieved Lincoln’s eloquence. He uses the same words over and over again because they successfully work up the crowd.\n\nConvincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving.\n\nBuried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position. If this were policy, Abraham Lincoln and Winston Churchill both would have been lost to history due to their battles with depression.\n\n## [Related: Psychiatry group tells members they can ignore ‘Goldwater rule’ and comment on Trump’s mental health](https:\/\/www.statnews.com\/2017\/07\/25\/psychiatry-goldwater-rule-trump\/)\nAssigning psychological disorders to Trump is not only wrong but futile. Vice President Pence, the Cabinet, and Congress would never [invoke the 25th Amendment](https:\/\/www.brookings.edu\/blog\/unpacked\/2017\/06\/09\/the-25th-amendment\/) because it would amount to political suicide for everyone concerned and for the Republican Party. Any psychological fitness exam would also be inherently biased and unreliable. My guess is that Trump will eventually be removed from power, but via the appropriate investigative and political process, not a psychiatric evaluation.\n\nI believe that Trump is a mirror of the American soul, a surface symptom of our deeper societal disease. He may not be crazy, but we certainly were for electing him. We mustn’t waste this Trumpian dark age. If we don’t learn from it, we will keep making the same mistakes.\n\n*Allen Frances, M.D., was chair of the Department of Psychiatry and Behavioral Sciences at Duke University and also chaired the task force responsible for revising the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. He is the author of “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump” (William Morrow, September 2017).*\n\n## About the Author  [Reprints](https:\/\/www.parsintl.com\/publications\/stat\/)\n### Allen Frances\n[@AllenFrancesMD](https:\/\/x.com\/AllenFrancesMD)\n\n## Tags\n[Donald Trump](https:\/\/www.statnews.com\/topic\/donald-trump\/)\n\n[Mental Health](https:\/\/www.statnews.com\/topic\/mental-health\/)\n\nTo submit a correction request, please visit our [Contact Us page](https:\/\/www.statnews.com\/contact\/?how_can_we_help_=Editorial%20Correction%20Request).\n\n## ![STAT+](https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/stat-plus-logo.svg)\n### Get unlimited access to the latest news and exclusive analysis.\n[Subscribe now](https:\/\/www.statnews.com\/stat-plus\/)\n\n## ![STAT+](https:\/\/www.statnews.com\/wp-content\/themes\/stat\/images\/stat-plus-logo.svg)\n### Catch up on the latest must-read coverage and analysis\n[Read 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Trump’s consistently bizarre sayings and doings have [triggered a bill](https:\/\/www.statnews.com\/2017\/08\/16\/donald-trump-mental-health-congress\/) to establish a commission “on presidential capacity” and a suggestion that the president be removed from office [via the 25th Amendment](http:\/\/www.politico.com\/story\/2017\/08\/23\/trump-california-mental-health-241915) on the grounds that he is mentally unfit to be president.\n\nA [recent Time poll](http:\/\/time.com\/4800080\/donald-trump-impeachment-poll\/) indicates that many Americans think that Trump is unfit for office. I also believe we made a terrible mistake electing him. But Trump’s disagreeable traits in no way indicate that he is mentally ill. Instead, they reveal him to be the ruthless self-promoter he has always been, now poorly cloaked in fake populist clothing.\n\nBefore I go any further, you should know that I am a lifelong political inactivist, shamefully missing in action from the tumultuous political events of the last 50 years. It took the travesty of a Trump presidency to get me fully engaged.\n\nConfusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed.\n\nTrump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the [Diagnostic and Statistical Manual of Mental Disorders](https:\/\/www.psychiatry.org\/psychiatrists\/practice\/dsm\/history-of-the-dsm) (DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way.\n\nMy long experience with psychiatric diagnosis has taught me a recurring and painful lesson: Anything that can be misused in the DSM will be misused, especially when there is an external, nonclinical reward for doing so. We decided to include narcissistic personality disorder in the DSM-III 40 years ago purely for clinical reasons. We never imagined it would be used as ammunition in today’s political warfare.\n\nIt’s also important to note that narcissistic personality disorder holds a fragile place in the diagnostic universe. It came quite close to being eliminated when the fifth edition of the DSM was published in 2013, and will be excluded from the forthcoming revision to the International Classification of Diseases, a set of codes used by physicians and other health care providers to classify diagnoses, symptoms, and procedures.\n\nSome presidential observers base their diagnosis of delusional disorder on Trump’s being an avid consumer and creator of conspiracy theories. He learned his art from a master: [his mentor, Roy Cohn](https:\/\/www.nytimes.com\/2016\/06\/21\/us\/politics\/donald-trump-roy-cohn.html?mcubz=0), who was the brains behind Sen. Joseph McCarthy’s attempt to control our government through Communist witch hunts in the 1950s. Conspiracy theorists are a dime a dozen, while those with delusions are more rare. Up to [half of all Americans](http:\/\/www.npr.org\/2014\/06\/04\/318733298\/more-americans-than-you-might-think-believe-in-conspiracy-theories) believe in strange conspiracy theories. They are wrong, but not delusional. Having a delusion means being a minority of one.\n\nAlso keep in mind that Trump’s conspiracy theories have been, and continue to be, essential to his political success. His [long-standing claim](http:\/\/www.cnn.com\/2016\/09\/09\/politics\/donald-trump-birther\/index.html) that President Obama was not born in the United States launched Trump’s presidential run, his “crooked Hillary” claims helped win him the election, and “fake news” holds his base in his thrall. Trump is [crazy like a fox](https:\/\/www.statnews.com\/2017\/01\/30\/trump-mental-health\/).\n\nThe dementia diagnosis is based on the supposed poverty and perseveration in [Trump’s current speech patterns](https:\/\/www.statnews.com\/2017\/05\/23\/donald-trump-speaking-style-interviews\/) compared to his earlier ones. I would attribute this to the number of stump speeches Trump has given. Abraham Lincoln could find creative ways of repeatedly saying the same thing, but Trump has never achieved Lincoln’s eloquence. He uses the same words over and over again because they successfully work up the crowd.\n\nConvincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving.\n\nBuried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position. If this were policy, Abraham Lincoln and Winston Churchill both would have been lost to history due to their battles with depression.\n\nAssigning psychological disorders to Trump is not only wrong but futile. Vice President Pence, the Cabinet, and Congress would never [invoke the 25th Amendment](https:\/\/www.brookings.edu\/blog\/unpacked\/2017\/06\/09\/the-25th-amendment\/) because it would amount to political suicide for everyone concerned and for the Republican Party. Any psychological fitness exam would also be inherently biased and unreliable. My guess is that Trump will eventually be removed from power, but via the appropriate investigative and political process, not a psychiatric evaluation.\n\nI believe that Trump is a mirror of the American soul, a surface symptom of our deeper societal disease. He may not be crazy, but we certainly were for electing him. We mustn’t waste this Trumpian dark age. If we don’t learn from it, we will keep making the same mistakes.\n\n*Allen Frances, M.D., was chair of the Department of Psychiatry and Behavioral Sciences at Duke University and also chaired the task force responsible for revising the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. He is the author of “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump” (William Morrow, September 2017).*","meta_canonical":null}

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Meta Title	I'm an expert on diagnosing mental illness. Trump doesn’t meet the criteria
Meta Description	Many people speculate on Donald Trump's alleged mental disorder. But he doesn't meet the criteria for mental illness. He's crazy like a fox.
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Boilerpipe Text	D iagnosing President Donald Trump’s alleged mental disorder has become a popular pastime, not just among mental health professionals but also among politicians, journalists, pundits, comedians, and ordinary people gathered at coffee breaks. Trump’s consistently bizarre sayings and doings have triggered a bill to establish a commission “on presidential capacity” and a suggestion that the president be removed from office via the 25th Amendment on the grounds that he is mentally unfit to be president. A recent Time poll indicates that many Americans think that Trump is unfit for office. I also believe we made a terrible mistake electing him. But Trump’s disagreeable traits in no way indicate that he is mentally ill. Instead, they reveal him to be the ruthless self-promoter he has always been, now poorly cloaked in fake populist clothing. Before I go any further, you should know that I am a lifelong political inactivist, shamefully missing in action from the tumultuous political events of the last 50 years. It took the travesty of a Trump presidency to get me fully engaged. Confusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed. Trump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way. My long experience with psychiatric diagnosis has taught me a recurring and painful lesson: Anything that can be misused in the DSM will be misused, especially when there is an external, nonclinical reward for doing so. We decided to include narcissistic personality disorder in the DSM-III 40 years ago purely for clinical reasons. We never imagined it would be used as ammunition in today’s political warfare. It’s also important to note that narcissistic personality disorder holds a fragile place in the diagnostic universe. It came quite close to being eliminated when the fifth edition of the DSM was published in 2013, and will be excluded from the forthcoming revision to the International Classification of Diseases, a set of codes used by physicians and other health care providers to classify diagnoses, symptoms, and procedures. Some presidential observers base their diagnosis of delusional disorder on Trump’s being an avid consumer and creator of conspiracy theories. He learned his art from a master: his mentor, Roy Cohn , who was the brains behind Sen. Joseph McCarthy’s attempt to control our government through Communist witch hunts in the 1950s. Conspiracy theorists are a dime a dozen, while those with delusions are more rare. Up to half of all Americans believe in strange conspiracy theories. They are wrong, but not delusional. Having a delusion means being a minority of one. Also keep in mind that Trump’s conspiracy theories have been, and continue to be, essential to his political success. His long-standing claim that President Obama was not born in the United States launched Trump’s presidential run, his “crooked Hillary” claims helped win him the election, and “fake news” holds his base in his thrall. Trump is crazy like a fox . The dementia diagnosis is based on the supposed poverty and perseveration in Trump’s current speech patterns compared to his earlier ones. I would attribute this to the number of stump speeches Trump has given. Abraham Lincoln could find creative ways of repeatedly saying the same thing, but Trump has never achieved Lincoln’s eloquence. He uses the same words over and over again because they successfully work up the crowd. Convincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving. Buried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position. If this were policy, Abraham Lincoln and Winston Churchill both would have been lost to history due to their battles with depression. Assigning psychological disorders to Trump is not only wrong but futile. Vice President Pence, the Cabinet, and Congress would never invoke the 25th Amendment because it would amount to political suicide for everyone concerned and for the Republican Party. Any psychological fitness exam would also be inherently biased and unreliable. My guess is that Trump will eventually be removed from power, but via the appropriate investigative and political process, not a psychiatric evaluation. I believe that Trump is a mirror of the American soul, a surface symptom of our deeper societal disease. He may not be crazy, but we certainly were for electing him. We mustn’t waste this Trumpian dark age. If we don’t learn from it, we will keep making the same mistakes. Allen Frances, M.D., was chair of the Department of Psychiatry and Behavioral Sciences at Duke University and also chaired the task force responsible for revising the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. He is the author of “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump” (William Morrow, September 2017).
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Test your knowledge with our new weekday mini crossword [Start solving](https://www.statnews.com/stat-mini-crossword/) [First Opinion](https://www.statnews.com/category/first-opinion/) # I helped write the manual for diagnosing mental illness. Donald Trump doesn’t meet the criteria By Allen FrancesSept. 6, 2017 [Reprints](https://www.parsintl.com/publications/stat/) ![Trump](https://www.statnews.com/wp-content/uploads/2017/09/GettyImages-837326796-645x645.jpg) Nicholas Kamm/AFP/Getty Images Diagnosing President Donald Trump’s alleged mental disorder has become a popular pastime, [not just among mental health professionals](https://www.statnews.com/2017/01/30/trump-mental-health/) but also among politicians, journalists, pundits, comedians, and ordinary people gathered at coffee breaks. Trump’s consistently bizarre sayings and doings have [triggered a bill](https://www.statnews.com/2017/08/16/donald-trump-mental-health-congress/) to establish a commission “on presidential capacity” and a suggestion that the president be removed from office [via the 25th Amendment](http://www.politico.com/story/2017/08/23/trump-california-mental-health-241915) on the grounds that he is mentally unfit to be president. A [recent Time poll](http://time.com/4800080/donald-trump-impeachment-poll/) indicates that many Americans think that Trump is unfit for office. I also believe we made a terrible mistake electing him. But Trump’s disagreeable traits in no way indicate that he is mentally ill. Instead, they reveal him to be the ruthless self-promoter he has always been, now poorly cloaked in fake populist clothing. Advertisement Before I go any further, you should know that I am a lifelong political inactivist, shamefully missing in action from the tumultuous political events of the last 50 years. It took the travesty of a Trump presidency to get me fully engaged. Confusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed. Trump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the [Diagnostic and Statistical Manual of Mental Disorders](https://www.psychiatry.org/psychiatrists/practice/dsm/history-of-the-dsm) (DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way. Advertisement My long experience with psychiatric diagnosis has taught me a recurring and painful lesson: Anything that can be misused in the DSM will be misused, especially when there is an external, nonclinical reward for doing so. We decided to include narcissistic personality disorder in the DSM-III 40 years ago purely for clinical reasons. We never imagined it would be used as ammunition in today’s political warfare. It’s also important to note that narcissistic personality disorder holds a fragile place in the diagnostic universe. It came quite close to being eliminated when the fifth edition of the DSM was published in 2013, and will be excluded from the forthcoming revision to the International Classification of Diseases, a set of codes used by physicians and other health care providers to classify diagnoses, symptoms, and procedures. Some presidential observers base their diagnosis of delusional disorder on Trump’s being an avid consumer and creator of conspiracy theories. He learned his art from a master: [his mentor, Roy Cohn](https://www.nytimes.com/2016/06/21/us/politics/donald-trump-roy-cohn.html?mcubz=0), who was the brains behind Sen. Joseph McCarthy’s attempt to control our government through Communist witch hunts in the 1950s. Conspiracy theorists are a dime a dozen, while those with delusions are more rare. Up to [half of all Americans](http://www.npr.org/2014/06/04/318733298/more-americans-than-you-might-think-believe-in-conspiracy-theories) believe in strange conspiracy theories. They are wrong, but not delusional. Having a delusion means being a minority of one. Also keep in mind that Trump’s conspiracy theories have been, and continue to be, essential to his political success. His [long-standing claim](http://www.cnn.com/2016/09/09/politics/donald-trump-birther/index.html) that President Obama was not born in the United States launched Trump’s presidential run, his “crooked Hillary” claims helped win him the election, and “fake news” holds his base in his thrall. Trump is [crazy like a fox](https://www.statnews.com/2017/01/30/trump-mental-health/). The dementia diagnosis is based on the supposed poverty and perseveration in [Trump’s current speech patterns](https://www.statnews.com/2017/05/23/donald-trump-speaking-style-interviews/) compared to his earlier ones. I would attribute this to the number of stump speeches Trump has given. Abraham Lincoln could find creative ways of repeatedly saying the same thing, but Trump has never achieved Lincoln’s eloquence. He uses the same words over and over again because they successfully work up the crowd. Convincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving. Buried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position. If this were policy, Abraham Lincoln and Winston Churchill both would have been lost to history due to their battles with depression. ## [Related: Psychiatry group tells members they can ignore ‘Goldwater rule’ and comment on Trump’s mental health](https://www.statnews.com/2017/07/25/psychiatry-goldwater-rule-trump/) Assigning psychological disorders to Trump is not only wrong but futile. Vice President Pence, the Cabinet, and Congress would never [invoke the 25th Amendment](https://www.brookings.edu/blog/unpacked/2017/06/09/the-25th-amendment/) because it would amount to political suicide for everyone concerned and for the Republican Party. Any psychological fitness exam would also be inherently biased and unreliable. My guess is that Trump will eventually be removed from power, but via the appropriate investigative and political process, not a psychiatric evaluation. I believe that Trump is a mirror of the American soul, a surface symptom of our deeper societal disease. He may not be crazy, but we certainly were for electing him. We mustn’t waste this Trumpian dark age. If we don’t learn from it, we will keep making the same mistakes. Allen Frances, M.D., was chair of the Department of Psychiatry and Behavioral Sciences at Duke University and also chaired the task force responsible for revising the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. He is the author of “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump” (William Morrow, September 2017). ## About the Author [Reprints](https://www.parsintl.com/publications/stat/) ### Allen Frances [@AllenFrancesMD](https://x.com/AllenFrancesMD) ## Tags [Donald Trump](https://www.statnews.com/topic/donald-trump/) [Mental Health](https://www.statnews.com/topic/mental-health/) To submit a correction request, please visit our [Contact Us page](https://www.statnews.com/contact/?how_can_we_help_=Editorial%20Correction%20Request). ## ![STAT+](https://www.statnews.com/wp-content/themes/stat/images/stat-plus-logo.svg) ### Get unlimited access to the latest news and exclusive analysis. 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Readable Markdown	Diagnosing President Donald Trump’s alleged mental disorder has become a popular pastime, [not just among mental health professionals](https://www.statnews.com/2017/01/30/trump-mental-health/) but also among politicians, journalists, pundits, comedians, and ordinary people gathered at coffee breaks. Trump’s consistently bizarre sayings and doings have [triggered a bill](https://www.statnews.com/2017/08/16/donald-trump-mental-health-congress/) to establish a commission “on presidential capacity” and a suggestion that the president be removed from office [via the 25th Amendment](http://www.politico.com/story/2017/08/23/trump-california-mental-health-241915) on the grounds that he is mentally unfit to be president. A [recent Time poll](http://time.com/4800080/donald-trump-impeachment-poll/) indicates that many Americans think that Trump is unfit for office. I also believe we made a terrible mistake electing him. But Trump’s disagreeable traits in no way indicate that he is mentally ill. Instead, they reveal him to be the ruthless self-promoter he has always been, now poorly cloaked in fake populist clothing. Before I go any further, you should know that I am a lifelong political inactivist, shamefully missing in action from the tumultuous political events of the last 50 years. It took the travesty of a Trump presidency to get me fully engaged. Confusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed. Trump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the [Diagnostic and Statistical Manual of Mental Disorders](https://www.psychiatry.org/psychiatrists/practice/dsm/history-of-the-dsm) (DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way. My long experience with psychiatric diagnosis has taught me a recurring and painful lesson: Anything that can be misused in the DSM will be misused, especially when there is an external, nonclinical reward for doing so. We decided to include narcissistic personality disorder in the DSM-III 40 years ago purely for clinical reasons. We never imagined it would be used as ammunition in today’s political warfare. It’s also important to note that narcissistic personality disorder holds a fragile place in the diagnostic universe. It came quite close to being eliminated when the fifth edition of the DSM was published in 2013, and will be excluded from the forthcoming revision to the International Classification of Diseases, a set of codes used by physicians and other health care providers to classify diagnoses, symptoms, and procedures. Some presidential observers base their diagnosis of delusional disorder on Trump’s being an avid consumer and creator of conspiracy theories. He learned his art from a master: [his mentor, Roy Cohn](https://www.nytimes.com/2016/06/21/us/politics/donald-trump-roy-cohn.html?mcubz=0), who was the brains behind Sen. Joseph McCarthy’s attempt to control our government through Communist witch hunts in the 1950s. Conspiracy theorists are a dime a dozen, while those with delusions are more rare. Up to [half of all Americans](http://www.npr.org/2014/06/04/318733298/more-americans-than-you-might-think-believe-in-conspiracy-theories) believe in strange conspiracy theories. They are wrong, but not delusional. Having a delusion means being a minority of one. Also keep in mind that Trump’s conspiracy theories have been, and continue to be, essential to his political success. His [long-standing claim](http://www.cnn.com/2016/09/09/politics/donald-trump-birther/index.html) that President Obama was not born in the United States launched Trump’s presidential run, his “crooked Hillary” claims helped win him the election, and “fake news” holds his base in his thrall. Trump is [crazy like a fox](https://www.statnews.com/2017/01/30/trump-mental-health/). The dementia diagnosis is based on the supposed poverty and perseveration in [Trump’s current speech patterns](https://www.statnews.com/2017/05/23/donald-trump-speaking-style-interviews/) compared to his earlier ones. I would attribute this to the number of stump speeches Trump has given. Abraham Lincoln could find creative ways of repeatedly saying the same thing, but Trump has never achieved Lincoln’s eloquence. He uses the same words over and over again because they successfully work up the crowd. Convincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving. Buried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position. If this were policy, Abraham Lincoln and Winston Churchill both would have been lost to history due to their battles with depression. Assigning psychological disorders to Trump is not only wrong but futile. Vice President Pence, the Cabinet, and Congress would never [invoke the 25th Amendment](https://www.brookings.edu/blog/unpacked/2017/06/09/the-25th-amendment/) because it would amount to political suicide for everyone concerned and for the Republican Party. Any psychological fitness exam would also be inherently biased and unreliable. My guess is that Trump will eventually be removed from power, but via the appropriate investigative and political process, not a psychiatric evaluation. I believe that Trump is a mirror of the American soul, a surface symptom of our deeper societal disease. He may not be crazy, but we certainly were for electing him. We mustn’t waste this Trumpian dark age. If we don’t learn from it, we will keep making the same mistakes. Allen Frances, M.D., was chair of the Department of Psychiatry and Behavioral Sciences at Duke University and also chaired the task force responsible for revising the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. He is the author of “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump” (William Morrow, September 2017).
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