The argument "diagnosis/no diagnosis" should be over with by now. A patient may be treated in a community mental health setting, then in a hospital, then elsewhere. The referring clinician needs to provide information about her difficulty, and diagnosis is a concise and helpful way of doing this. Her care will be paid for by an insurance company or a government entity, which usually (whether we like it or not) will ask for a number to ensure they have a disease that "meets criteria." Careful training in diagnosis is needed to ensure health professionals don't have a cavalier attitude towards the diagnoses they provide; but simply sticking to the criteria outlined in the IV-TR helps ward off such lack of carefulness. It also helps make it more likely that Dr. X in San Francisco is talking about the same thing when he says "schizophrenia, paranoid type" as Dr. Y in Virginia Beach when he says "schizophrenia, paranoid type." Such reliability is essential in our continued research on mental illness and substance abuse.That said, a clinician in a hospital or clinic setting who needs to understand or determine diagnosis can benefit from both the hardcover versions of the DSM-IV-TR and this spiral bound version. I myself have the hardbound DSM-IV, and instead of purchasing both TR's, simply purchased the spiral-bound DSM-IV-TR. The spiral bound is essential because, with so much use, a glued binding will quickly fall apart. As a clinician currently assigned to a county hospital screening site, I carry my little spiral book everywhere. It fits easily into my purse, but it's not so small that the print is hard to read. There is even a pull-out of all the diagnoses at the beginning that's handy to glance at or tack on the wall.You will need the hardbound because of the additional information, but if your work requires you to do evaluations in a variety of settings, or even if you know you will be referring to it often and don't want to be bothered getting the big one off the shelf, definitely purchase this one as well.Kelly L. Norman, ACSW