DISORDER CRITERIA SPECIFIER PREVALENCE CULTURE-RELATED GENDER-RELEATED DIFFERENTIAL COMORBIDITY

DIAGNOSIS
Disruptive A. Repeated and intense episodes of Common Sociocultural factors Irritability has a Bipolar disorders Oppositional defiant
Mood anger expressed through words or among determine how the strong genetic disorder
Dysregulati actions that greatly exceed the children disorder's underlying component in both Oppositional defiant
on Disorder appropriate level for the presenting to psychological traits males and females, disorder. Disruptive behavior,
(F34.81) circumstances or trigger. pediatric are exhibited, however the patterns mood
B. The outbursts do not align with the mental health including impulsivity, differ across the Attention-
individual's stage of development. clinics. emotional sexes, based on twin deficit/hyperactivity Anxiety
C. Anger outbursts occur at least three dysregulation, studies. In boys, disorder, major
times per week. A cohort study impaired reward genetic factors seem depressive disorder, Autism spectrum
D. Outside of temper outbursts, the of 11-year-old processing, perceived to contribute anxiety disorders, and symptoms
individual's mood is consistent with Brazilians threat sensitivity, and increasingly to the autism spectrum
irritability or anger for the majority of utilizing a behavioral variability of disorder.
the day, almost every day, and is specific dysregulation. This irritability traits
visible to others. module for effect is especially during childhood. Intermittent explosive
E. The symptoms outlined in Criteria disruptive noticeable in While genetic factors disorder.
A–D have persisted – 12 months or mood situations play a substantial role
longer. During this time, there has not dysregulation characterized by in the irritability
been a stretch of 3 or more months disorder severe social phenotype among
without having all the symptoms listed revealed a upheaval, such as school-age girls, this
in Criteria A-D. prevalence of post-conflict zones or contribution
F. Criteria A and D are present in at 2.5%. communities dealing diminishes during
least 2 of the 3 situations, and they with racism and adolescence and early
are particularly severe in one of them. discrimination. adulthood, with
G. Diagnosis should not be made for environmental factors
the first time before age 6 years or becoming more
after age 18 years. influential.
H. Age at onset of Criteria A–E is
before 10 years.
I. There hasn't been a separate
instance lasting over a day where all
the symptoms required for a manic or
hypomanic episode, except for
duration, were fulfilled.
J. Behaviors are not limited to major
depression episodes and cannot be
appropriately attributed to another
mental disease.
K. Symptoms are not caused by the
physiological effects of a
substance/medical/neurological
disorder.
Major A. Five (or more) of the following With anxious The 12-month Symptoms of major In general, women Manic episodes with Substance-related
Depressive symptoms have been present during distress prevalence of depressive disorder experience irritable mood or with Disorders
Disorder the same 2-week period and represent major may not be fully disturbances in eating mixed features.
a change from previous functioning; at With mixed depressive diagnosed or and sleeping, with Panic disorder
least one of the symptoms is either (1) features disorder in the acknowledged, some reporting Bipolar I disorder,
depressed mood or (2) loss of interest United States resulting in unusual symptoms bipolar II disorder, or Generalized anxiety
or pleasure. With melancholic is approx. 7%, misdiagnosis, like as increased other specified bipolar disorder
1. Subjective reports show a features with large including the appetite and and related disorder.
depressed mood almost every day. variability possibility of excessive sleep. They Posttraumatic stress
2. Significantly reduced enjoyment or With atypical among age overdiagnosis of are also more Depressive disorder disorder
interest in nearly all activities features groups. schizophrenia susceptible to due to another
throughout most of the day. Notably, spectrum disorders, interpersonal medical condition. Obsessivecompulsive
3. Noticeable changes in weight, With mood- persons aged particularly among sensitivity and disorder
either loss without intentional dieting congruent 18 to 29 have certain ethnic and digestive problems. Substance/medication
or gain, as well as fluctuations in psychotic a threefold racial groups who -induced depressive Anorexia nervosa
appetite occurring almost daily. features higher experience discriminat Men with depression, disorder.
4. Insomnia or hypersomnia nearly frequency ion. on the other hand, Bulimia nervosa
every day. With mood- than those may utilize more Persistent depressive
5. Psychomotor agitation or incongruent aged 60 and In the United States, maladaptive coping disorder. Borderline personality
retardation nearly every day psychotic up. major depressive and problem-solving disorder.
6. Fatigue or loss of energy nearly features disorder appears to mechanisms, such as Premenstrual
every day. last longer in African alcohol or substance dysphoric disorder. In women – anxiety
7. Nearly every day, you have With catatonia Americans and abuse, risky actions, disorders, bulimia
excessive or inappropriate sentiments Caribbean Blacks than and difficulty Disruptive mood nervosa, and
of worthlessness or guilt. With peripartum in non-Latinx Whites, controlling impulses, dysregulation somatoform disorder
8. Reduced capacity to think, onset possibly due to the than women with disorder.
concentrate, or indecisiveness nearly effects of racism, depression. In men – alcohol and
everyday. With seasonal discrimination, Major depressive substance abuse
9. Frequent thoughts of death, not just pattern increased episodes
fear of dying, recurring suicidal sociostructural superimposed on
thoughts without a clear plan, real challenges, and schizophrenia,
suicide attempts, or detailed plans to limited access to high- delusional disorder,
end one's life. quality mental health schizophreniform
B. The symptoms cause noticeable services. disorder, or other
distress or impairment in social, specified or
occupational, or other important areas unspecified
of functioning, requiring clinical schizophrenia
attention. spectrum and other
C. The episode cannot be explained by psychotic disorder.
the physiological effects of a
substance or another medical Schizoaffective
condition. disorder.
D. At least one major depressive
episode cannot be better explained by Attention-
schizoaffective disorder, and it does deficit/hyperactivity
 not occur concurrently with disorder.
schizophrenia, schizophreniform
disorder, delusional disorder, or any Adjustment disorder
other specified or unspecified with depressed mood.
schizophrenia spectrum and other
psychotic disorders. Bereavement.
E. There has never been a manic
episode or a hypomanic episode. Sadness.
Persistent A. Feeling consistently down for most With anxious In the United The perception of Major depressive anxiety disorders
Depressive of the day, on more days than not, as distress States, the 12- chronic depression disorder
Disorder reported subjectively or observed by month symptoms as substance use
(F34.1) others, for a duration of at least 2 With atypical prevalence is abnormal or bearable Other specified disorders
years. features roughly 0.5% varies by culture, depressive disorder.
B. Presence, while depressed, of 2 (or for dysthymic influencing symptom personality disorders
more) of the following: In partial disorder and identification and Bipolar I and bipolar II
1. Poor appetite or overeating. remission 1.5% for accept therapy. For disorders.
2. Insomnia or hypersomnia. chronic major example, certain
3. Low energy or fatigue. In full remission depressive socioeconomic or age Cyclothymic disorder.
4. Low self-esteem. disorder. groups may regard
5. Poor concentration or difficulty Early onset: If Among persistent depressed Psychotic disorders.
making decisions. onset is before women, the symptoms as normal
6. Feelings of hopelessness. age 21 years. prevalence for responses to difficult Depressive or bipolar
C. Throughout the two-year period of each of these situations. and related disorder
disturbances, the individual has not Late onset: If diagnoses is due to another
gone more than two months without onset is at age 21 approximately medical condition.
experiencing the symptoms described years or older. 1.5 to 2 times
in Criteria A and B. higher Substance/medication
D. The criteria for a major depressive With pure compared to -induced depressive
disorder may persist uninterrupted for dysthymic men. or bipolar and related
a period of 2 years. syndrome disorder.
E. There has never been a manic
episode or a hypomanic episode. With persistent Personality disorders.
F. The disturbance cannot be major depressive
explained more correctly by an episode
ongoing schizoaffective disease,
schizophrenia, delusional disorder, or With intermittent
any other identified or unspecified major depressive
schizophrenia spectrum or other episodes, with
psychotic disorder. current episode

G. The symptoms cannot be attributed With intermittent

to the physiological effects of a major depressive
substance or another medical episodes, without
condition. current episode
 H. The symptoms cause noticeable Mild
distress or impairment in social,
occupational, or other crucial areas of Moderate
functioning, necessitating therapeutic
evaluation. Severe

Premenstru A. During most menstrual cycles, at A large study Premenstrual Premenstrual - Migraine
al Dysphoric least five symptoms must appear in conducted in dysphoric disorder has syndrome. - Asthma
Disorder the final week before menstruation Germany been identified in - Allergies
(F32.81) begins. These symptoms usually estimated the individuals across Dysmenorrhea. - seizure
improve after a few days of 12-month various regions disorders
menstruation and become minor or prevalence of including the United Bipolar disorder, - depressive
absent in the week following premenstrual States, Europe, India, major depressive and bipolar
menstruation. dysphoric Nigeria, Brazil, and disorder, and disorders
B. One (or more) of the following disorder in the Asia, showing a wide persistent depressive - anxiety
symptoms must be present: community to prevalence range. disorder. disorders
1. Marked affective lability be 5.8%. However, like many - bulimia
2. Marked irritability or anger or mental disorders, the Use of hormonal nervosa
increased interpersonal conflicts. Another study frequency, severity, treatments. - substance use
3. Marked depressed mood, feelings examining and expression of disorders
of hopelessness, or self-deprecating prevalence symptoms, perceived Other medical
thoughts. over two impact, help-seeking conditions.
4. Marked anxiety, tension, and/or menstrual behaviors, and
feelings of being keyed up or on edge. cycles treatment approaches
C. Criterion C requires the presence of reported that can be greatly
one or more additional symptoms, in 1.3% of influenced by social
addition to those listed in Criterion B, menstruating and cultural factors.
to reach a total of five symptoms. women in the These may include
1. Decreased interest in usual United States factors such as a
activities were affected history of sexual
2. Subjective difficulty in by the abuse or domestic
concentration. disorder. violence, limited social
3. Lethargy, easy fatigability, or support, and cultural
marked lack of energy. attitudes towards
4. Marked change in appetite; menstruation.
overeating; or specific food cravings.
5. Hypersomnia or insomnia.
6. A sense of being overwhelmed or
out of control.
7. Physical symptoms such as breast
tenderness or swelling, joint or muscle
pain, a sensation of “bloating,” or
weight gain.
D. The symptoms lead to significant
distress or disruption in work, school,
 regular social activities, or
relationships with others.
E. The disturbance is more than just a
worsening of symptoms from another
disorder, such as major depressive
disorder, panic disorder, persistent
depressive disorder, or personality
disorder.
F. Criterion A should be confirmed by
prospective daily ratings during at
least two symptomatic cycles.
G. The symptoms are not attributable
to the physiological effects of a
substance or another medical
condition.
Substance/ A. A noticeable and long-lasting With onset during The lifetime In individuals with a Substance
Medication- disruption in mood, characterized by intoxication occurrence substance use intoxication and
Induced feelings of depression or a major lack has been disorder, the withdrawal.
Depressive of interest or pleasure in almost all With onset during documented likelihood of
Disorder activities. withdrawal to be 40% or developing a Independent
B. There is evidence from the history, more in substance-induced depressive disorder.
physical examination, or laboratory With onset after individuals depressive disorder
findings of both (1) and (2): medication use with related seems to be Depressive disorder
1. The symptoms mentioned in substance use comparable between due to another
Criterion A appeared during or disorders. men and women. medical condition.
immediately after substance
intoxication or withdrawal, or after In United
exposure to or withdrawal from States, the
medications. lifetime
2. The substance or medication prevalence,
involved has the potential to cause the without a
symptoms outlined in Criterion A. history of non-
C. The disruption is not more substance-
accurately accounted for by a non- induced
substance/medication-induced depressive
depressive disorder. Evidence of an disorder, was
independent depressive disorder found to be
could include the following: only 0.26%.
The symptoms occurred before the
initiation of substance/medication
use, persist for a considerable
duration following the cessation of
acute withdrawal or severe
intoxication, or there are indications
pointing to the presence of a separate
 non-substance/medication-induced
depressive disorder.
D. The disturbance does not occur
exclusively during a delirium.
E. The disturbance causes severe
distress or impairment in social,
occupational, or other crucial areas of
functioning, requiring clinical
intervention.
Depressive A. Common and long-lasting F06.31 With Variations in Women have higher Depressive disorders Cushing’s disease
Disorder disturbance in mood that is evident in depressive prevalence risk of experiencing not due to another
Due to the clinical presentation, characterized features between sexes depression, medical condition.
Another by feelings of depression or a major are influenced particularly following
Medical decrease in interest or enjoyment in F06.32 With partly by the a stroke, within the Medication-induced
Condition practically all activities. major gender context of depressive disorder.
B. The medical history, physical exam, depressive–like disparity cardiovascular
or lab test provide evidence that the episode linked with the disease Delirium and major or
disturbance is caused by the medical mild neurocognitive
pathophysiology of another medical F06.34 With condition. disorder.
illness. mixed features
C. Disturbance is not better explained Adjustment disorders.
by another mental disorder.
D. Disturbance does not occur Demoralization.
exclusively during delirium.
E. Disturbance causes clinically
significant distress or impairment in
social, occupational, or other
important areas of functioning.
Other 1. Recurrent brief depression
Specified 2. Short-duration depressive
Depressive episode (4–13 days)
Disorder 3. Depressive episode with
(F32.89) insufficient symptoms
4. Major depressive episode
superimposed
Unspecified The unspecified depressive disorder category is
Depressive used when a clinician chooses not to explain why
Disorder the criteria for a specific depressive disorder are
(F32.A) not met. It includes cases where there is
insufficient information to provide a more
specific diagnosis, such as in emergency rooms.
Unspecified This category is relevant to cases where
Mood symptoms typical of a mood disorder causing
Disorder significant distress/impairment in various areas
(F39) of life are prominent, but at the time of
 assessment, they do not fully align with the
criteria for any specific disorders within either
the bipolar or depressive disorder diagnostic
categories. It can also be challenging to
distinguish between unspecified bipolar and
related disorders and unspecified depressive
disorders, especially in cases involving acute
agitation.
Specifiers With anxious distress:
for 1. Feeling keyed up or tense.
Depressive 2. Feeling unusually restless.
Disorders 3. Difficulty concentrating because of worry.
4. Fear that something awful may happen.
5. Feeling that the individual might lose control of himself or herself.
Mild: Two symptoms.
Moderate: Three symptoms.
Moderate-severe: Four or five symptoms.
Severe: Four or five symptoms and with motor agitation.

With mixed features:

During most days in the current major depressive episode, there are at least 3 of the following symptoms of
mania/hypomania present.
1. Elevated, expansive mood.
2. Inflated self-esteem or grandiosity.
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Increase in energy or goal-directed activity.
6. Increased or excessive involvement in activities that have a high potential
for painful consequences
7. Decreased need for sleep
B. Mixed symptoms are noticeable to others and indicate a departure from the individual's typical behavior.
C. If an individual's symptoms meet the full criteria for either mania or hypomania, the diagnosis should be bipolar I or
bipolar II disorder.
D. Mixed symptoms cannot be attributed to the physiological effects of a substance.
With melancholic features:
A. One of the following is present during the most severe period of the current major depressive episode
1. Loss of pleasure in all, or almost all, activities.
2. Lack of reactivity to usually pleasurable stimuli
B. Three (or more) of the following:
1. A distinct quality of depressed mood characterized by profound despondency, despair, and/or moroseness or by so-
called empty mood.
2. Depression is regularly worse in the morning.
3. Early-morning awakening
4. Marked psychomotor agitation or retardation.
5. Significant anorexia or weight loss.
6. Excessive or inappropriate guilt.

With atypical features:

A. Mood reactivity
B. Two (or more) of the following:
1. Significant weight gain or increase in appetite.
2. Hypersomnia.
3. Leaden paralysis
4. A long-standing pattern of interpersonal rejection sensitivity
that results in significant social or
occupational impairment.
C. Criteria are not met for “with melancholic features” or “with catatonia” during the same episode.

With psychotic features:

With mood-congruent psychotic features

With mood-incongruent psychotic features

With catatonia

With peripartum onset

With seasonal pattern:

A. Has a consistent temporal pattern linking the beginning of major depressive episodes in major depressive disorder
with a specific time of the year.
B. Full remissions also occur at a characteristic time of the year
C. Over the past 2 years, there have been two major depressive episodes that adhere to the seasonal patterns described
previously, with no occurrence of nonseasonal major depressive episodes during the same timeframe.
D. Episodes of major depression associated with seasons significantly surpass the occurrences of nonseasonal major
depressive episodes throughout the individual's lifetime.

In partial remission:
In full remission:
Mild:
Moderate:
Severe: