Twenty years ago, slightly after the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition was published, we predicted the characteristics of the future Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (). Included in our predictions were how many diagnoses it would contain, the physical size of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition), who its leader would be, how many professionals would be involved in creating it, the revenue generated, and the color of its cover. This article reports on the accuracy of our predictions. Our largest prediction error concerned financial revenue. The earnings growth of the DSM's has been remarkable. Drug company investments, insurance benefits, the financial need of the American Psychiatric Association, and the research grant process are factors that have stimulated the growth of the DSM's. Restoring order and simplicity to the classification of mental disorders will not be a trivial task.