The way the idea of pathology was taught to me when I took my introductory Psychology classes was framed more in relationship to the idea of healthy functioning. This meant being able to fulfill obligations like being able to work and take care of yourself but also recognizing conditions whose harm is more internally felt.
This definition presented to me doesn't entirely escape Foucault's view of your environment determining what is or isn't a pathology, but when it was taught to me it felt like a reflection of a less socially determined view of mental illness. Mental illness has gained a greater emphasis on helping to improve the personal mental state of the individual irrespective of social expectations. Maybe I am being more idealistic with this thinking.
It would interesting to hear from someone with more professional experience on this since I've only dabbled with a few college classes and books on the subject so my knowledge is quite limited.
The only thing that's changed is what we consider pathological.
I guess the suggestion here is entrepreneurs are much more likely to develop or amplify existing mental health issues (anxiety, impostor syndrome, depression, financial stress)
Personally, I think of an entrepreneur as a strictly business decision. Set specific goals that need to be met in order to determine future sustainability. If goals are not met. Then shelf the project and cut your losses.
The added stress of wearing multiple hats is acknowledged though. I’m not much of a marketing type person and getting that right is often half the battle.
Also, you are making the banal mistake of reading "entrepreneur" as a synonym of the big evil Fortune 500 CEO. A shoemaker, for example, is an entrepreneur, a niche that does not benefit from being a sociopath. But it does massively help for being the CEO of Nestlé or any other megacorporation.