Changes in the DSM-5 for Bipolar Disorder

Table of ContentsView AllTable of ContentsHistory of the DSMChanges in DSM-5Bipolar Disorder in the DSM-5Bipolar Disorder in the DSM-5-TR

Table of ContentsView All

View All

Table of Contents

History of the DSM

Changes in DSM-5

Bipolar Disorder in the DSM-5

Bipolar Disorder in the DSM-5-TR

The DSM is important because it contains diagnostic codes for mental illnesses, similar to those for physical illnesses. For example, if a doctor orders blood tests and gives you a paper to take to the lab, the lab may insist that there be a diagnostic code on the order because they have to provide it to aninsurance company.

It’s the same with mental illnesses: A psychiatrist can’t simply tell your insurance, “This patient hasbipolar disorder.” A specific code must be provided for thetypeof bipolar disorder.

The first edition of the DSM was published in 1952, listing 102 broad categories of disorders.Each of these included a short list of symptoms, along with some information about suspected causes.

The 1968 version contained 100 disorders, and in 1979, the third edition shifted away from psychoanalytic emphasis, contained over 200 diagnostic categories, and introduced themulti-axial system(Axis I to Axis V).

The term “mental retardation” is no longer used, as many consider it offensive and misleading. With the release of the DSM-5-TR (DSM-5, text revision), the term “intellectual development disorder (intellectual disability)” is now used.

DSM-IV was first published in 1994, and a revised edition was released in 2000, called the DSM-IV-TR (though the “TR,” or text revision, often wasn’t included in articles referencing the manual). While sticking with the Axis system, this edition broke diagnoses and symptoms down into sections or “decision trees,” including which symptomsmustbe included for a diagnosis and whichmust notbe present.

Published in 2013, the DSM-5 makes many changes. The most obvious of these is the switch from using Roman to Arabic numerals (it’s called the DSM-5 instead of DSM-V).

Another significant change is that the Axis system was dropped. Instead, there are 20 chapters containing categories of related disorders. “Bipolar and Related Disorders” is one such category. Other examples are:

One of the controversies is that the DSM-5 reclassified Asperger’s syndrome (AS) underautism spectrum disorder. Research reveals that many people who had initially received this diagnosis considered the new categorization a “threat to their identity, social status, and access to supports.”

Even thoughchildhood bipolar disorderhas been well-defined and used for many years, pediatric bipolar disorder is not a new diagnosis in the DSM-5. Instead, a category of depressive disorders has been added calleddisruptive mood dysregulation disorder(DMDD). The driver for this was a concern that the diagnosis of pediatric bipolar disorder was being inconsistently and overly applied to different types of childhood irritability.

For bipolar disorder under the DSM-5, there are nowseven possible diagnoses:

Additional changes include:

Each type of bipolar disorder has what are calledspecifiers(such as “with mixed features,” above or other specifiers such as “with anxious distress” or “with rapid cycling”) that further clarify the illness.

The DSM-5-TR, issued in 2022, made some further changes to bipolar disorder. Criterion B in bipolar I disorder was revised.

The DSM-5-TR text indicates that in bipolar I, a manic episode can’t be “superimposed on” (occur on top of) an existing diagnosis of schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified psychotic disorder.

The specifiers for manic episodes were updated in the DSM-5-TR to the following:

What to Know About the DSM-5-TR

3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kawa S, Giordano J.A brief historicity of theDiagnostic and Statistical Manual of Mental Disorders: issues and implications for the future of psychiatric canon and practice.Philos Ethics Humanit Med. 2012;7(2). doi:10.1186/1714-5341-7-2American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text revision. American Psychiatric Publishing.Huynh S, McCrimmon A, Strong T.The change in classification of Asperger syndrome: an exploration of its effects on self-identity.The Qualitative Report. 2020;25(2):379-98.Additional ReadingAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Publishing.

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kawa S, Giordano J.A brief historicity of theDiagnostic and Statistical Manual of Mental Disorders: issues and implications for the future of psychiatric canon and practice.Philos Ethics Humanit Med. 2012;7(2). doi:10.1186/1714-5341-7-2American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text revision. American Psychiatric Publishing.Huynh S, McCrimmon A, Strong T.The change in classification of Asperger syndrome: an exploration of its effects on self-identity.The Qualitative Report. 2020;25(2):379-98.Additional ReadingAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Publishing.

Kawa S, Giordano J.A brief historicity of theDiagnostic and Statistical Manual of Mental Disorders: issues and implications for the future of psychiatric canon and practice.Philos Ethics Humanit Med. 2012;7(2). doi:10.1186/1714-5341-7-2American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text revision. American Psychiatric Publishing.Huynh S, McCrimmon A, Strong T.The change in classification of Asperger syndrome: an exploration of its effects on self-identity.The Qualitative Report. 2020;25(2):379-98.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text revision. American Psychiatric Publishing.

Huynh S, McCrimmon A, Strong T.The change in classification of Asperger syndrome: an exploration of its effects on self-identity.The Qualitative Report. 2020;25(2):379-98.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Publishing.

Meet Our Review Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?HelpfulReport an ErrorOtherSubmit

What is your feedback?