ifier is now included for bizarre type delusions to provide continuity with DSM-IV. Criteria for
catatonia are described uniformly across DSM-5. Fu rthermore, catatonia may be diagnosed
with a specifier (for depressive, bipolar, and psychotic disorders, incl uding schizophrenia), in
the context of a known medical condition,  or as an other specified diagnosis.
Bipolar and Related Disorders
Diagnostic criteria for bipolar disorders  now include both changes in mood and changes in
activity or energy. The DSM-IV diagnosis of bipolar I disorder, mixed episodes—requiring
that the individual simultaneous ly meet full criteria for both mania and major depressive ep-
isode—is replaced with a new specifier “with mixed features.” Particular conditions can
now be diagnosed under other specified bipolar and related disorder, including categori-
zation for individuals with a past history of  a major depressive di sorder whose symptoms
meet all criteria for hypomania except the duration criterion is  not met (i.e., the episode lasts
only 2 or 3 days instead of the required 4 cons ecutive days or more). A second condition con-
stituting an other specified bipolar and related disorder variant is that too few symptoms of
hypomania are present to meet criteria for the full bipolar II syndrome, although the dura-
tion, at least 4 consecutive days, is sufficient. Finally, in both this chapter and in the chapter
“Depressive Disorders,” an anxious distress specifier is delineated.
Depressive Disorders
To address concerns about potential overdiagno sis and overtreatment of bipolar disorder in
children, a new diagnosis, disruptive mood dysregulation disorder,  is included for children
up to age 18 years who exhibit persistent irrita bility and frequent episodes of extreme behav-