a disorder are experienced by an individual . Attention-deficit/hype ractivity disorder is
an example of a disorder with differences in  presentation that are most commonly expe-
rienced by boys or girls. Gender likely has other effects on the experience of a disorder that
are indirectly relevant to psychiatric diagnosis. It may be that certain symptoms are more
readily endorsed by men or women, and that this contributes to differences in service pro-
vision (e.g., women may be more likely to recognize a depr essive, bipolar, or anxiety dis-
order and endorse a more comprehen sive list of symptoms than men). 
Reproductive life cycle events, including estr ogen variations, also contribute to gender
differences in risk and expression of illness. Thus, a specifier for postpartum onset of mania
or major depressive episode denotes a time frame wherein women may be at increased risk
for the onset of an illness episode. In the case  of sleep and energy, alterations are often nor-
mative postpartum and thus may have lower diagnostic reliability in postpartum women. 
The manual is configured to include information on gender at  multiple levels. If there
are gender-specific symptoms, th ey have been added to the di agnostic criteria. A gender-
related specifier, such as perinatal onset of a mood episode, provides additional informa-
tion on gender and diagnosis. Finally, other issues that are pertinent to diagnosis and gen-
der considerations can be found in the se ction “Gender-Related Diagnostic Issues.”
Use of Other Specified and Unspecified Disorders
To enhance diagnostic specificity, DSM-5 repl aces the previous NOS designation with two
options for clinical use: other specified disorder  and unspecified disorder.  The other specified
disorder category is provided to allow the clinician to communicate the specific reason