2/24/23, 3:57 PM Table 11, DSM-IV to DSM-5 Manic Episode Criteria Comparison - DSM-5 Changes - NCBI Bookshelf

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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child
Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services
Administration (US); 2016 Jun.

Table 11 DSM-IV to DSM-5 Manic Episode Criteria Comparison

DSM-IV Criteria DSM-5 Criteria

Name: Bipolar I Disorder Single Manic

Episode Name: Bipolar I Disorder Manic Episode
Class: Bipolar Disorders Class: Bipolar and Related Disorders

A. A distinct period of abnormally and A. A distinct period of abnormally and

persistently elevated, expansive, or irritable
mood, lasting at least 1 week (or any duration
if hospitalization is necessary).
persistently elevated, expansive, or irritable
mood and abnormally and persistently goal-
directed behavior or energy, lasting at least 1
week and present most of the day, nearly every
day (or any duration if hospitalization is
necessary).

B. During the period of mood disturbance,
three (or more) of the following symptoms
have persisted (four if the mood is only
irritable) and have been present to a
significant degree:
 1. Inflated self-esteem or grandiosity
 2. Decreased need for sleep (e.g., feels
rested after only 3 hours of sleep)
 3. More talkative than usual or pressure to
keep talking
 4. Flight of ideas or subjective experience
that thoughts are racing
B. During the period of mood disturbance and
increased energy or activity, three (or more) of
the following symptoms have persisted (four if
the mood is only irritable) are present to a
significant degree and represent a noticeable
change from usual behavior:
 1. Same
 2. Same
 3. Same
 4. Same

 5. Distractibility (i.e., attention too easily
drawn to unimportant or irrelevant external
stimuli)
 6. Increase in goal-directed activity (either  6. Same
socially, at work or school, or sexually) or
psychomotor agitation
 7. Excessive involvement in pleasurable
activities that have a high potential for painful
consequences (e.g., engaging in unrestrained
buying sprees, sexual indiscretions, or foolish
business investments)
 5. Distractibility (i.e., attention too easily
drawn to unimportant or irrelevant external
stimuli), as reported or observed.
 7. Excessive involvement in activities that
have a high potential for painful consequences
(e.g., engaging in unrestrained buying sprees,
sexual indiscretions, or foolish business
investments).

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2/24/23, 3:57 PM Table 11, DSM-IV to DSM-5 Manic Episode Criteria Comparison - DSM-5 Changes - NCBI Bookshelf

DSM-IV Criteria DSM-5 Criteria

Name: Bipolar I Disorder Single Manic

Episode Name: Bipolar I Disorder Manic Episode
C. The symptoms do not meet criteria for a Dropped
mixed episode.

D. The mood disturbance is sufficiently C. The mood disturbance is sufficiently severe

severe to cause marked impairment in
occupational functioning or in usual social
activities or relationships with others, or to
necessitate hospitalization to prevent harm to
self or others, or there are psychotic features.
to cause marked impairment in social or
occupational functioning or to necessitate
hospitalization to prevent harm to self or others,
or there are psychotic features.

E. The symptoms are not due to the direct D. The episode is not attributable to the direct
physiological effects of a substance (e.g., a physiological effects of a substance (e.g., a drug
drug of abuse, a medication, or other of abuse, a medication, or other treatment) or
treatment) or a general medical condition another medical condition.
(e.g., hyperthyroidism). Note: A full manic episode that emerges during
Note: Manic-like episodes that are clearly antidepressant treatment (e.g., medication,
caused by somatic antidepressant treatment electroconvulsive therapy) but persists at fully
(e.g., medication, electroconvulsive therapy, syndromal level beyond the physiological effect
light therapy) should not count toward a of that treatment is sufficient evidence for a
diagnosis of bipolar I disorder. manic episode and therefore a bipolar I
diagnosis.
From: 3, DSM-5 Child Mental Disorder Classification
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