[_delirium]

A particularly tricky aspect for the purposes of this discussion is that the positions on those spectra are somewhat circularly defined when looking at outcomes, at least as defined in the DSM, the most common U.S. diagnostic manual. Many of the conditions have outcome-related diagnostic factors right in the definitions: whether the person is experiencing significant distress in their life, conflict with others or their surroundings, inability to work a job, etc. The pragmatic goal is to avoid over-diagnosing things that aren't actually causing people problems, but as a result it's tricky to isolate causal factors. Even worse if you're diagnosing people in retrospect: of course someone who went on a shooting rampage is going to meet all those criteria, after the fact.