Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison - DSM-5 Changes

DSM-IV Disorder	DSM-IV Criteria	DSM-5 Disorder	DSM-5 Criteria
Disorder Class	Mood Disorders	Disorder Class	Bipolar and Related Disorders
Bipolar Disorder	DSM-IV specified 6 “types” of bipolar I disorder: Bipolar I disorder, single manic episode Bipolar I disorder, most recent episode hypomanic Bipolar I disorder, most recent episode manic Bipolar I disorder, most recent episode mixed Bipolar I disorder, most recent episode depressed Bipolar I disorder, most recent episode unspecified	Bipolar I Disorder	A. Criteria have been met for at least one manic episode (Table 11). The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes (see Table 9). B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. Note: Major depressive episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder. Note: Hypomanic episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder. Specify: With anxious distress With mixed features With rapid cycling With melancholic features With atypical features With mood-congruent psychotic features With mood-incongruent psychotic features With catatonia With peripartum onset With seasonal pattern Specify: Remission status if full criteria are not currently met for a manic, hypomanic, or major depressive episode.
Bipolar I Disorder, Single Manic Episode	A. Presence of only one manic episode (see Table 11) and no past major depressive episodes (see Table 9). Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms. B. The manic episode is not better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Specify if: Mixed: if symptoms meet criteria for a mixed episode Specify (for current or most recent episode): Severity/psychotic/remission specifiers With catatonic features With postpartum onset		Bipolar I episode “types” dropped from criteria tables, but diagnostic procedure still includes noting most recent episode type.
Bipolar I Disorder, Most Recent Episode Hypomanic	A. Currently (or most recently) in a hypomanic episode. B. There has previously been at least one manic episode or mixed episode. C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The mood episodes in Criteria A and B are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Specify: Longitudinal course specifiers (with and without interepisode recovery) With seasonal pattern (applies only to the pattern of major depressive episodes) With rapid cycling		Bipolar I episode “types” dropped from criteria tables, but diagnostic procedure still includes noting most recent episode type.
Bipolar I Disorder, Most Recent Episode Manic	A. Currently (or most recently) in a manic episode. B. There has previously been at least one major depressive episode, manic episode, or mixed episode. C. The mood episodes in Criteria A and B are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Specify (for current or most recent episode): Severity/psychotic/remission specifiers With catatonic features With postpartum onset Specify: Longitudinal course specifiers (with and without interepisode recovery) With seasonal pattern (applies only to the pattern of major depressive episodes) With rapid cycling		Bipolar I episode “types” dropped from criteria tables, but diagnostic procedure still includes noting most recent episode type.
Bipolar I Disorder, Most Recent Episode Mixed	A. Currently (or most recently) in a mixed episode. B. There has previously been at least one major depressive episode, manic episode, or mixed episode. C. The mood episodes in Criteria A and B are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Specify (for current or most recent episode): Severity/psychotic/remission specifiers With catatonic features With postpartum onset Specify: Longitudinal course specifiers (with and without interepisode recovery) With seasonal pattern (applies only to the pattern of major depressive episodes) With rapid cycling		Bipolar I episode “types” dropped from criteria tables, but diagnostic procedure still includes noting most recent episode type.
Bipolar I Disorder, Most Recent Episode Depressed	A. Currently (or most recently) in a major depressive episode. B. There has previously been at least one manic episode or mixed episode. C. The mood episodes in Criteria A and B are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Specify (for current or most recent episode): Severity/psychotic/remission specifiers Chronic With catatonic features With melancholic features With atypical features With postpartum onset Specify: Longitudinal course specifiers (with and without interepisode recovery) With seasonal pattern (applies only to the pattern of major depressive episodes) With rapid cycling		Bipolar I episode “types” dropped from criteria tables, but diagnostic procedure still includes noting most recent episode type.
Bipolar I Disorder, Most Recent Episode Unspecified	A. Criteria, except for duration, are currently (or most recently) met for a manic, a hypomanic, a mixed, or a major depressive episode. B. There has previously been at least one manic episode or mixed episode. C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The mood symptoms in Criteria A and B are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified
	E. The mood symptoms in Criteria A and B are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). Specify: Longitudinal course specifiers (with and without interepisode recovery) With seasonal pattern (applies only to the pattern of major depressive episodes) With rapid cycling		Dropped

DSM-IV Disorder

DSM-IV Criteria

DSM-5 Disorder

DSM-5 Criteria

Disorder Class

Mood Disorders

Disorder Class

Bipolar and Related Disorders

Bipolar Disorder

DSM-IV specified 6 “types” of bipolar I disorder:

Bipolar I disorder, single manic episode
Bipolar I disorder, most recent episode hypomanic
Bipolar I disorder, most recent episode manic
Bipolar I disorder, most recent episode mixed
Bipolar I disorder, most recent episode depressed
Bipolar I disorder, most recent episode unspecified

Bipolar I Disorder

A. Criteria have been met for at least one manic episode (Table 11). The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes (see Table 9).
B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
Note: Major depressive episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder.
Note: Hypomanic episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder.
Specify:

With anxious distress
With mixed features
With rapid cycling
With melancholic features
With atypical features
With mood-congruent psychotic features
With mood-incongruent psychotic features
With catatonia
With peripartum onset
With seasonal pattern

Specify: Remission status if full criteria are not currently met for a manic, hypomanic, or major depressive episode.

Bipolar I Disorder, Single Manic Episode

A. Presence of only one manic episode (see Table 11) and no past major depressive episodes (see Table 9).
Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms.
B. The manic episode is not better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified.
Specify if:

Mixed: if symptoms meet criteria for a mixed episode

Specify (for current or most recent episode):

Severity/psychotic/remission specifiers
With catatonic features
With postpartum onset