Bipolar and Related Disorders

Bipolar and related disorders are found between the chapters on schizophrenia spectrum and other psychotic disorders and depressive disorders in DSM-5-TR in recognition of their place as a bridge between those two diagnostic classes in terms of symptomatology, family history, and genetics. The diagnoses included in this chapter are 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 , and unspecified bipolar and related disorder . The bipolar I disorder criteria represent the modern understanding of the classic manic-depressive disorder or affective psychosis described in the nineteenth century, differing from that classic description only to the extent that neither psychosis nor the lifetime experience of a major depressive episode is a requirement. However, the vast majority of individuals whose symptoms meet the criteria for a fully syndromal manic episode also experience major depressive episodes during the course of their lives. Bipolar II disorder , requiring the lifetime experience of at least one major depressive episode and at least one hypomanic episode (but no history of mania), is no longer thought to be a less severe condition than bipolar I disorder , largely because of the burden of depression in bipolar II disorder and because the instability of mood experienced by individuals with bipolar II disorder is often accompanied by serious impairment in work and social functioning. The diagnosis of cyclothymic disorder is given to adults who experience at least 2 years (for children, a full year) of both hypomanic and depressive periods without ever fulfilling the criteria for an episode of mania, hypomania, or major depression. A large number of substances of abuse, some prescribed medications, and several medical conditions can be associated with manic-like phenomena. This fact is recognized in the diagnoses of substance/medication-induced bipolar and related disorder and bipolar and related disorder due to another medical condition. The recognition that there are individuals who experience bipolar-like phenomena with symptoms that do not meet the criteria for bipolar I, bipolar II, or cyclothymic disorder is reflected in the availability of the other specified bipolar and related disorder category. Specific criteria for a disorder involving short-duration hypomania are provided in Section III in the hope of encouraging further study of this presentation of bipolar disorder symptomatology and its course.