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Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.
| DSM-IV | DSM-5 |
|---|---|
| Diagnostic Class: Conditions for further study1 | Diagnostic Class: Depressive Disorders |
| A. In most menstrual cycles during the past year, five (or more) of the following symptoms occurred during the final week before the onset of menses, started to improve within a few days after the onset of menses, and were minimal or absent in the week postmenses, with at least one of the symptoms being either (1), (2), (3), or (4): | A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses. |
| B. One (or more) of the following symptoms may be present: | |
| 1. markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts | 3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts. |
| 2 marked anxiety, tension, feelings of being “keyed up” or “on edge” | 4. Marked anxiety, tension, and/or feelings of being keyed up or on edge. |
| 3. marked affective lability (e.g., mood swings; feeling suddenly sad or tearful or increased sensitivity to rejection) | 1. Marked affective lability (e.g., mood swings; feeling suddenly sad or tearful or increased sensitivity to rejection). |
| 4. persistent and marked anger or irritability or increased interpersonal conflicts | 2. Marked irritability or anger or increased interpersonal conflicts. |
| C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above. | |
| 5. decreased interest in usual activities (e.g., work, school, friends, hobbies) | 1. Decreased interest in usual activities (e.g., work, school, friends, hobbies). |
| 6. subjective sense of difficulty in concentration | 2. Subjective difficulty in concentration. |
| 7. lethargy, easy fatigability, or marked lack of energy | 3. Lethargy, easy fatigability, or marked lack of energy. |
| 8. marked change in appetite, overeating, or specific food cravings | 4. Marked change in appetite; overeating; or specific food cravings. |
| 9. hypersomnia or insomnia | 5. Hypersomnia or insomnia. |
| 10. a subjective sense of being overwhelmed or out of control | 6. A sense of being overwhelmed or out of control. |
| 11. other physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” weight gain | 7. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain. |
| Note: In menstruating females, the luteal phase corresponds to the period between ovulation and the onset of menses, and the follicular phase begins with menses. In nonmenstruating females (e.g., those who have had a hysterectomy), the timing of luteal and follicular phases may require measurement of circulating reproductive hormones. | Note: The symptoms in Criteria A–C must have been met for most menstrual cycles that occurred in the preceding year. |
| B. The disturbance markedly interferes with work or school or with usual social activities and relationships with others (e.g., avoidance of social activities, decreased productivity and efficiency at work or school). | D. The symptoms are associated with clinically significant distress or interferences with work, school, usual social activities or relationships with others (e.g., avoidance of social activities, decreased productivity and efficiency at work, school or home). |
| C. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, dysthymic disorder, or a personality disorder (although it may be superimposed on any of these disorders). | E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders). |
| D. Criteria A, B, and C should be confirmed by prospective daily ratings during at least two symptomatic cycles. (The diagnosis may be made provisionally prior to this confirmation.) | F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation.) |
| G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism). | |
In DSM-IV, individuals whose presentation meets these research criteria would be diagnosed as having depressive disorder not otherwise specified. The transient mood changes that many females experience around the time of menses should not be considered a mental disorder. Premenstrual dysphoric disorder should be considered only when the symptoms markedly interfere with work or school or with usual social activities and relationships with others.
From: 3, Mental Illness
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