DSM-5-TR SUMMARIES 2
DSM-5-TR Summaries: Initial Assignment
Bipolar Disorders
Overview
Bipolar and associated bipolar disorders are characterized by cyclical episodes of manic-
depressive states, acting as an intermediary between psychotic and depressive disorders (Kring &
Johnson, 2022). The distinction among these disorders is determined by the intensity or the
temporal duration of these episodes (DSM-5, 2022).
Disorders
For a diagnosis of Bipolar I Disorder, the presence of at least one manic episode in the client’s
lifetime is requisite, provided it cannot be better accounted for by a diagnosis of schizophrenia
spectrum and other psychotic disorders (DSM-5-TR, 2022) . This can manifest with or without
accompanying hypomanic and depressive episodes. The diagnostic criteria for Bipolar II
Disorder necessitate the occurrence of at least one hypomanic episode and one depressive
episode, but the presence of manic episodes is explicitly excluded. Cyclothymic disorder is
diagnosed when the client exhibits hypomanic and depressive episodes that do not meet the
severity and symptom criteria for Bipolar I, Bipolar II, or any disorder within the schizophrenia
spectrum and other psychotic disorders category. The symptoms must have been present for at
least two years, and persist for at least half of that time, and the client must not have been
symptom-free for more than two months consecutively (DSM-5, 2022).
Risk and prognostic factors
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Bipolar I may include childhood adversity and recent life stress. Negative events can
precipitate depressive relapses, while manic relapses may be linked to life-attainment goals.
Although the risk in the general population is 1%, genetic factors may exert a substantial
influence on predisposition, accounting for as much as 90% of the risk (DSM-5, 2022).
Depressive Disorders
Overview
Depressive disorders are characterized by a constellation of symptoms including
pervasive sadness, feelings of emptiness, or irritable mood, accompanied by cognitive and
somatic changes that significantly impair an individual’s functioning. Distinctions among these
disorders are delineated by their causation, duration, temporal patterns, and underlying etiology
(Kring & Johnson, 2022).
Disorders
Disruptive Mood Dysregulation Disorder (abbreviated as DMDD) is identified by severe
temperamental outbursts—both verbal and physical—that are disproportionate to the
precipitating events or circumstances. The hallmark of DMDD is persistent and intense
irritability, with diagnostic criteria requiring onset prior to the age of ten. Major Depressive
Disorder (MDD) is diagnosed when an individual exhibits five or more symptomatic criteria
within a consistent two-week timeframe, predominantly throughout the day, including either a
depressed mood or a marked decrease in interest or pleasure. Additional manifestations may
encompass notable weight change, altered appetite, sleep disturbances, fatigue, cognitive
impairment, recurrent thoughts of death or suicidal ideation, and pervasive feelings of
DSM-5-TR SUMMARIES 4
hopelessness or self-deprecation. Persistent Depressive Disorder (PDD), also known as
dysthymia, mirrors many MDD symptoms but is diagnosed when the symptomatology extends
over a period of two years or longer. Premenstrual Dysphoric Disorder (PMDD) is characterized
by symptom onset during the week preceding menstruation, with improvement upon the
commencement of menses, and minimal or absent symptoms following the menstrual period.
Substance/Medication-Induced Depressive Disorder is recognized when depressive symptoms
emerge concomitantly with substance intoxication or withdrawal, or following exposure to or
cessation of medication(DSM-5, 2022).
Risk and Prognostic Factors
In Persistent Depressive Disorder, temperamental factors such as heightened neuroticism
and increased symptom severity may predict a less favorable long-term outcome. Risk factors
encompass experiences of parental loss or separation and childhood adversity. Genetic
predispositions are also notable, with a higher incidence of PDD observed among first-degree
relatives. Neurobiological research implicates various cerebral regions in the pathophysiology of
this disorder (DSM-5, 2022).
Anxiety Disorders
Overview
Anxiety disorders all share the symptoms of excessive fear and anxiety, with behavioral
disturbances. The difference between the disorders is dependent on the stimuli that cause the
client’s fear, anxiety, avoidance behavior, and related cognition and typically last more than 6
months. Panic attacks are common with anxiety disorders (Kring & Johnson, 2022).
DSM-5-TR SUMMARIES 5
Disorders
Anxiety disorders, while sharing common symptoms of excessive fear and anxiety
leading to behavioral disturbances, are differentiated by the specific stimuli that incite fear,
anxiety, avoidance behavior, and related cognitions in the individual. These symptoms generally
persist for a period exceeding six months, with panic attacks being a frequent occurrence.
Separation Anxiety Disorder, which can occur in both children and adults, is characterized by the
fear and anxiety experienced during separation from home or attachment figures. Selective
Mutism is marked by an inability to speak in certain social situations, often accompanied by
excessive shyness, fear of social embarrassment, isolation, withdrawal, and clinging behavior.
Specific Phobia involves intense fear or anxiety triggered by a specific object or situation, with
diagnostic criteria including avoidance of the phobic stimulus, consistent provocation of fear and
anxiety by the phobic stimulus, and significant distress persisting for more than six months.
Social Anxiety Disorder is triggered by social situations that expose the individual to potential
judgement by others. Panic Disorder involves an abrupt surge of intense fear and anxiety that
triggers numerous physiological reactions, often accompanied by recurrent, unexpected panic
attacks. Agoraphobia involves fear or anxiety associated with being in open or enclosed spaces,
leaving the home or being outside, using public transportation, or being in a line or a crowd.
Generalized Anxiety Disorder involves persistent fear, worry, and anxiety about a variety of
events or activities, which do not fit the criteria for other disorders and occurs frequently for at
least six months (DSM-5, 2022).
Risk and Prognostic Factors
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Panic Disorder related to temperament includes neuroticism, sensitivity to anxiety,
behavioral inhibition, and harm avoidance. At the same time, environmental risk factors
encompass smoking, specific stressors before onset, separation, overprotective parenting, and
parental rejection (DSM-5, 2022).
