The most recently published Diagnostic and Statistical Manual of Mental Disorders is the Fifth Edition, or the DSM 5. The DSM is the classification and diagnostic tool by the American Psychiatric Association (APA), utilized by mental health practitioners. In the United States, the DSM is considered the universal authority for psychiatric diagnosis as well as treatment recommendations, among others.
The DSM 5, which was officially released in 2013, supersedes the DSM-IV-TR, published in 2000. The new edition has brought about significant changes in the diagnostic criteria and texts. The APA has provided a practical guide indicating the highlights of the changes from DSM IV-TR to DSM 5, and here are the changes made under Bipolar and Related Disorders.
Bipolar and Related Disorders
Bipolar Disorders
To enhance the accuracy of diagnosis and facilitate earlier detection in clinical settings, Criterion A for manic and hypomanic episodes now includes an emphasis on changes in activity and energy as well as mood. The DSM-IV diagnosis of bipolar I disorder, mixed episode, requiring that the individual simultaneously meet full criteria for both mania and major depressive episode, has been removed. Instead, a new specifier, "with mixed features," has been added that can be applied to episodes of mania or hypomania 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 Specified Bipolar and Related Disorder
DSM-5 allows the specification of particular conditions for other specified bipolar and related disorder, including categorization for individuals with a past history of a major depressive disorder who meet all criteria for hypomania except the duration criterion (i.e., at least 4 consecutive days). A second condition constituting another specified bipolar and related disorder is that too few symptoms of hypomania are present to meet criteria for the full bipolar II syndrome, although the duration is sufficient at 4 or more days.
Anxious Distress Specifier
In the chapter on bipolar and related disorders and the chapter on depressive disorders, a specifier for anxious distress is delineated. This specifier is intended to identify patients with anxiety symptoms that are not part of the bipolar diagnostic criteria.