There are people for whom it hasn't sunk in yet that it's a thing you don't say, and then there are jerks.

Hmmm. I think it has well evolved beyond being a medical term of any kind and is now just an expression for somebody who is being stupid. There is a big difference being somebody who is stupid (something I would never say someone is), and somebody who is being stupid, which most of us do at least once a day.