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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.

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DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet].

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

DSM-IV DisorderDSM-IV CriteriaDSM-5 DisorderDSM-5 Criteria
Disorder ClassMood DisordersDisorder ClassBipolar and Related Disorders
Bipolar DisorderDSM-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 DisorderA. 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 EpisodeA. 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 HypomanicA. 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 ManicA. 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 MixedA. 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 DepressedA. 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 UnspecifiedA. 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

From: 3, DSM-5 Child Mental Disorder Classification

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