Depression and Bipolar info explaining the latest research in everyday English


Bipolar in the new DSM-5

Windpump. Copyright Lee Hopkins 2015

The DSM-5 sees greater clarity in how Bipolar Disorder is viewed. There is now less risk of seeing oneself put in a vague NOS ‘not otherwise specified’ group, and several new subthreshold groups of depression, bipolar disorders and mixed states are now operationally defined.

These subthreshold groups will stimulate research and allow for a more dimensional view of Bipolar Disorder and Depression. For depression, for example, recurrent brief depression and even short-duration depressive episodes (4 to 13 days), as well as 2-week episodes with insufficient symptoms, now have their place.

But, for no apparent reason, DSM-5 classifies some patients as having subthreshold bipolar disorders who would formerly have been diagnosed with manic episodes or bipolar I or II disorders.

It is estimated that DSM-5 bipolar II disorder will be diagnosed about twice as often as it has previously been and will have a prevalence approaching that of bipolar I. A more frequent diagnosis of bipolar II disorder is both justified and logical: a milder condition (in this case hypomania) is usually more prevalent than a severe one (mania). Over the long-term course of their illness, bipolar patients spend much more time in milder conditions, mainly minor depression, than in major syndromes (Phillips and Kupfer 2013).

Overall, then, the growth of bipolar II disorder into a disorder recognised in its own right, rather than a ‘lite’ version of bipolar I disorder, will continue.


Angst, J. 2013. Bipolar disorders in DSM-5: strengths, problems and perspectives. International Journal of Bipolar Disorders 2013, 1:12

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