Bipolar and Related Disorders
Bipolar Disorders
To enhance the accuracy of diagnosis and facilitate earlier detec on in clinical se ngs, Criterion A for manic and hypomanic episodes now includes an emphasis on changes in ac vity and energy as well as mood. The DSM-IV diagnosis of bipolar I disorder, mixed episode, requiring that the individual simulta- neously meet full criteria for both mania and major depressive episode, has been removed. Instead, a new speci er, “with mixed features,” has been added that can be applied to episodes of mania or hy- pomania when depressive features are present, and to episodes of depression in the context of major depressive disorder or bipolar disorder when features of mania/hypomania are present.
Other Speci ed Bipolar and Related Disorder
DSM-5 allows the speci ca on of par cular condi ons for other speci ed bipolar and related disorder, including categoriza on for individuals with a past history of a major depressive disorder who meet all criteria for hypomania except the dura on criterion (i.e., at least 4 consecu ve days). A second condi- on cons tu ng an other speci ed bipolar and related disorder is that too few symptoms of hypoma- nia are present to meet criteria for the full bipolar II syndrome, although the dura on is su cient at 4 or more days.
Anxious Distress Speci er
In the chapter on bipolar and related disorders and the chapter on depressive disorders, a speci er for anxious distress is delineated. This speci er is intended to iden fy pa ents with anxiety symptoms that are not part of the bipolar diagnos c criteria.