gruent:
With mood-congruent psychotic features: During manic episodes, the con-
tent of all delusions and hallucinations is consistent with the typical manic
themes of grandiosity, invulnerability, etc., but may also include themes of sus-
piciousness or paranoia, especially with respect to others’ doubts about the in-
dividual’s capacities, accomplishments, and so forth.
With mood-incongruent  psychotic features:  The content of delusions and
hallucinations is inconsistent with the episode polarity themes as described
above, or the content is a mixture of mood-incongruent and mood-congruent
themes.
With catatonia:  This specifier can apply to an episode of mania or depression if cata-
tonic features are present during most of the episode. See criteria for catatonia asso-
ciated with a mental disorder in the chapter “Schizophrenia Spectrum and Other
Psychotic Disorders.”
With peripartum onset: This specifier can be applied to the current or, if the full crite-
ria are not currently met for a mood episode, most recent episode of mania, hypoma-
nia, or major depression in bipolar I or bipol ar II disorder if onset of mood symptoms
occurs during pregnancy or in the 4 weeks following delivery.
Note:  Mood episodes can have their onset either during pregnancy or postpartum.
Although the estimates differ according to the period of follow-up after delivery, be-
tween 3% and 6% of women will experience the onset of a major depressive epi-
sode during pregnancy or in the weeks or months following delivery. Fifty percent
of “postpartum” major depressive episodes actually begin prior to delivery. Thus,
these episodes are referred to collectively as peripartum episodes. Women with