The new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) has a number of changes to bipolar disorders (also known to some by their old label, manic depression). This article outlines some of the major changes to these conditions.
According to the American Psychiatric Association (APA), the publisher of the DSM-5, only minor changes were made to this category of diagnoses.
According to the APA, in order to enhance the accuracy of diagnosis and facilitate earlier detection in clinical settings, the primary criteria for manic and hypomanic episodes (Criterion A) now includes an emphasis on changes in activity and energy — not just 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 from the DSM-5.
Instead, a new specifier, “with mixed features,” has been added, according to the APA, that can be applied to episodes of mania or hypomania when depressive features are present. It can also be applied to episodes of depression — such as in the context of major depressive disorder or bipolar disorder — when features of mania/hypomania are present.
Other Specified Bipolar and Related Disorder
According to the APA, the “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 an other 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 now defined. This specifier is intended to identify patients with anxiety symptoms that
are not part of the bipolar diagnostic criteria.