when necessary.
Elements of a Diagnosis
Diagnostic Criteria  and Descriptors
Diagnostic criteria are offered as guidelines for making diagnoses, and their use should be
informed by clinical judgment. Text descript ions, including introductory sections of each
diagnostic chapter, can help support diagnosis (e.g., providing differential diagnoses; de-
scribing the criteria more fully  under “Diagnostic Features”). 
Following the assessment of diagnostic criter ia, clinicians should consider the applica-
tion of disorder subtypes and/ or specifiers as appropriate. Severity and course specifiers
should be applied to denote the individual’s current presentation, but only when the full
criteria are met. When full criteria are no t met, clinicians should consider whether the
symptom presentation meets crit eria for an “other specified” or “unspecified” designa-
tion. Where applicable, specific criteria for defining disorder severity (e.g., mild, moder-
ate, severe, extreme), descriptive features (e.g.,  with good to fair insight; in a controlled
environment), and course (e.g., in partial remi ssion, in full remission, recurrent) are pro-
vided with each diagnosis. On the basis of the clinical interview, text descriptions, criteria,
and clinician judgment, a final diagnosis is made.
The general convention in DSM-5 is to allo w multiple diagnoses to be assigned for
those presentations that meet criteria  for more than one DSM-5 disorder.
Subtypes and Specifiers
Subtypes and specifiers (some of which are code d in the fourth, fifth, or sixth digit) are
provided for increased specificity. Subtypes  define mutually exclusive and jointly exhaus-
tive phenomenological subgroupings within a diagnosis and are indicated by the instruc-
tion “ Specify  whether” in the criteria set. In contrast, specifiers  are not intended to be