Changes in the DSM-5 and DSM-5-TR on Bipolar Disorder

Diagnostic and Statistical Manual of Mental Disorders (DSM)

• The DSM is a publication of the American Psychiatric Association that provides formal criteria for classifying and diagnosing mental illnesses.
• It is important for insurance purposes and communication between healthcare providers.

History of the DSM

• The first edition was published in 1952 with 102 broad categories of disorders.
• The DSM-IV was published in 1994 and revised in 2000. It introduced the multi-axial system and contained over 200 diagnostic categories.
• The DSM-5 was published in 2013 and made several significant changes, including dropping the Axis system and reclassifying Asperger's syndrome under autism spectrum disorder.
• The DSM-5-TR was issued in 2022 with further revisions.

Bipolar Disorder in the DSM-5

• Seven possible diagnoses:
  • Bipolar I disorder
  • Bipolar II disorder
  • Cyclothymic disorder
  • Substance/medication-induced bipolar and related disorder
  • Bipolar and related disorder due to another medical condition
  • Other specified bipolar and related disorder
  • Unspecified bipolar and related disorder
• Changes from previous DSM versions:
  • Elimination of the "mixed episode" diagnosis.
  • Inclusion of a history of mixed episodes as a criterion for bipolar II disorder.
  • Change in the criteria for a hypomanic episode to include the word "abnormally."

Bipolar Disorder in the DSM-5-TR

• Additional changes in the most recent edition:
  • Revised criteria for bipolar I disorder to exclude manic episodes occurring on top of schizophrenia or another psychotic disorder.
  • Changed severity specifiers for manic episodes.

Significance of These Changes

• Reflect ongoing research and evolving understanding of bipolar disorder.
• Aim to improve accuracy of diagnosis and guide treatment decisions.