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the addition of the requirement that at least one of the Criterion A symptoms
reliability, and poor validity. Instead, a dimensional approach to rating severity for
bridged by this condition—and requires that a major mood episode be present for
a majority of the total disorder's duration after Criterion A has been met. Criterion
A for delusional disorder no longer has the requirement that the delusions must
continuity with DSM-IV. Criteria for catatonia are described uniformly across
changes in mood and changes in activity or energy. The DSM-IV diagnosis of bipolar I
disorder, mixed episodes—requiring that the individual simultaneously meet full criteria
for both mania and major depressive episode—is replaced with a new specifier "with
mixed features." Particular conditions can now be diagnosed under other specified
bipolar and related disorder, including categorization for individuals with a past history of
a major depressive disorder whose symptoms meet all criteria for hypomania except the
duration criterion is not met (i.e., the episode lasts only 2 or 3 days instead of the
specified bipolar and related disorder variant is that too few symptoms of hypomania are
present to meet criteria for the full bipolar II syndrome, although the duration, at least 4
consecutive days, is sufficient. Finally, in both this chapter and in the chapter
included for children up to age 18 years who exhibit persistent irritability and frequent
promoted from Appendix B, "Criteria Sets and Axes Provided for Further Study," in
DSM-IV to the main body of DSM-5. What was referred to as dysthymia in DSM-IV now
falls under the category of persistent depressive disorder, which includes both chronic
major depressive disorder and the previous dysthymic disorder. The coexistence within
criteria for a manic episode) is now acknowledged by the specifier"with mixed features."
In DSM-IV, there was an exclusion criterion for a major depressive episode that was
applied to depressive symptoms lasting less than 2 months following the death of a
loved one (i.e., the bereavement exclusion). This exclusion is omitted in DSM-5 for
generally beginning soon after the loss, and can add an additional risk for suffering,
interpersonal and work functioning. It was critical to remove the implication that
bereavement typically lasts only 2 months, when both physicians and grief counselors
recognize that the duration is more commonly 1-2 years. A detailed footnote has
replaced the more simplistic DSM-IV exclusion to aid clinicians in making the critical
symptoms has been added across both the bipolar and the depressive disorders.