DSM-5-TR SUMMARIES 2
DSM-5-TR Summaries
All the following information was taken from the Diagnostic and Statistical Manual 5th
Edition (American Psychiatric Association, 2022) unless otherwise noted.
Bipolar and Related Disorders
Overview
The section containing diagnostical information for bipolar disorder and disorders related
to it is purposely located between chapters on psychotic disorders and depressive disorders
because of the way that the diagnostic criteria seemingly bridge these two clusters of disorders
together. What all disorders in this category share is that they all explain numerous fluctuations
between hypomanic and depressive moods and behavior found in the people who have them. The
severity and longevity of these states determine which disorder the person likely has.
Disorders
A diagnosis of Bipolar I disorder requires the client to meet the criteria for a manic
episode which follows a period of hypomania or episode of major depression and may also be
followed by a period of hypomania or episode of major depression. The manic episode also
should not otherwise be diagnosable as symptomatic of any disorders from the schizophrenia
spectrum or its related psychotic disorders. A diagnosis of Bipolar II disorder requires virtually
the same criteria aside from the presence of one manic episode. The third disorder in this group
is cyclothymic disorder and it is diagnosable when an individual has experienced numerous
periods of either hypomanic or depressive symptoms, but they do not fully meet the criteria for
hypomania, major depression, or mania.
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Risk and Prognostic Factors
Individuals seem to have a higher likelihood of developing bipolar disorder following a
childhood in which traumatic experiences, parental psychopathological issues, and family
conflict were present. That same adversity may lead to a worse prognosis and clinical scenario
such as the presence of medical or psychiatric comorbidities, an increased risk of suicide, and the
manifestation of associated psychotic features. Genetically, bipolar disorder shares a genetic
origin with schizophrenia, and genetics play a large role in one’s predisposition to the
development of bipolar disorder.
Depressive Disorders
Overview
All the disorders in this section share a common feature characterized by the existence of
a sad, empty, or irritable mood, coupled with associated changes that markedly impact the
individual's ability to function. This dysfunction can show up as either somatic and cognitive
changes in major depressive disorder or persistent depressive disorder. What distinguishes them
are variations in terms of duration, timing, or presumed underlying causes.
Disorders
This group of disorders includes major depressive disorder, characterized by episodes
lasting at least 2 weeks with changes in affect, cognition, and neurovegetative functions, as well
as inter-episode remissions. Recurrence of these depressive periods is common, and
distinguishing normal sadness from a major depressive episode is essential. Persistent depressive
disorder is diagnosed when mood disturbance persists for at least 2 years in adults or 1 year in
children. Premenstrual dysphoric disorder is a specific and treatment-responsive form of
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depressive disorder linked to the menstrual cycle. Additionally, substance/medication-induced
depressive disorder and depressive disorder due to another medical condition acknowledge the
association of depression-like symptoms with substances, medications, or medical conditions.
Risk and Prognostic Factors
Risk factors for major depressive disorder (MDD) can look like anything from biological
factors and medical conditions to psychological and environmental factors. Even an individual’s
personality traits are considered risk factors for depressive disorders. As far as prognosis, MDD
can recur many times in someone’s life with all episodes varying in length. The impacts of these
episodes can look like functional impairment and suicidal risk. The presence of comorbid
conditions can depend on the individual’s response to medications and other treatments, and both
substance use and the presence of anxiety can affect the course and prognosis.
Anxiety Disorders
Overview
Anxiety disorders are characterized by a common set of symptoms such as excessive fear and
anxiety accompanied by behavioral disturbances. The distinction between distinct types of
anxiety disorders lies in the specific experiences that trigger the client's fear, anxiety, avoidance
behavior, and related cognitive responses, typically persisting for more than six months.
Additionally, panic attacks are frequently associated with anxiety disorders.
Disorders
Separation anxiety disorder manifests in both children and adults and is characterized by
apprehension and unease about being apart from parental or other attachment figures. Selective
mutism involves the inability to speak in specific social situations, accompanied by excessive
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shyness, fear of social embarrassment, isolation, and withdrawal. Specific phobia entails an
intense fear or anxiety related to a particular object or situation, marked by criteria such as
persistent avoidance, consistent fear response, and significant distress lasting more than six
months. Social anxiety disorder emerges when fear or anxiety is triggered by social situations
involving potential judgment from others. Panic disorder entails sudden, intense surges of fear
and anxiety, leading to various physiological reactions and recurrent, unexpected panic attacks.
Agoraphobia involves fear or anxiety related to open spaces, enclosed spaces, leaving the home,
using public transportation, or being in a crowd. Generalized anxiety disorder is characterized by
persistent fear, worry, and anxiety not fitting other specific criteria, occurring frequently for at
least six months, and concerning various events or activities.
Risk and Prognostic Factors
The onset of separation anxiety disorder is influenced by various risk factors and exhibits
a complex interplay of environmental, genetic, physiological, and cultural elements.
Environmental stressors, such as life changes and childhood bullying, contribute to its
development. Genetic heritability, particularly in girls, and heightened sensitivity to respiratory
stimulation are identified physiological factors. Cultural norms play a role, with variations in
separation expectations across different societies. The disorder is associated with an increased
risk of suicidal thoughts, and functional consequences include significant limitations in
independent activities. The impact of separation anxiety disorder is reported to be more profound
in high- and upper-middle-income countries than in low- and lower-middle-income countries.
Understanding these factors is crucial for accurate diagnosis, effective intervention, and
improved prognosis.
