Diagnostic criteria and codes - Autism spectrum disorder - specifiers for bipolar and related disorders

6 important questions on Diagnostic criteria and codes - Autism spectrum disorder - specifiers for bipolar and related disorders

Specifier: with anxious distress

With anxious distress. At least two of the following.
  • Tense, restless, no concentration because of worry, fear for something awful to happen, feeling one might lose control of himself.
  • Specify severity (amount of sympt.) : Mild (2), Moderate (3), Moderate-severe (4,5), severe (4,5 + motor agitation) 

Specifier: with mixed features

  • Manic or hypomanic episode with mixed features (at least 3 symptoms during most days) Depressed mood, diminished interest/pleasure, psychomotor retardation, fatigue, feelings of worthlessness, thoughts of death Criteria for Mania and depression simultaneously, diagnosis: manic episode with mixed features
  • Depressive episode with mixed features. (at least 3 symptoms during most days): Expansive mood, inflated self-esteem, more talkative, fight of ideas, increased energy, decreased need for sleep. 

Specifier: with rapid cycling

With rapid cycling (can be for both bipolar disorders)
  • 4 mood episodes in the last 12 months that meet criteria for manic, hypomanic or depressive episode. 
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Specifier: with melancholic features

With melancholic features
  • One of: loss of pleasure, lack of reactivity to usually pleasurable stimuli. At least 3 of: Depressed mood, morning depression, early-morning awakening, Psychomotor agitation or retaradation, guilt, weight loss. 

Specifier: with atypical features

With atypical features
  • Mood reactivity (mood brightens in response to positive events)
  • Two or more of: weight gain, hypersomnia, leaden paralysis (leaden feeling in arms or legs), interpersonal rejection pattern 

Specifier: with psychotic features

Delusions or hallucinations are present at any time of episode. Mood-congruent or incongruent.

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