title: [Bipolar disorders in DSM-5].
abstract: BACKGROUND
  In spring 2013 the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) edited by the American Psychiatric Association was published. The DSM-5 has also brought some important changes regarding bipolar disorders.
  
  
  OBJECTIVE
  The goal of this manuscript is to review the novelties in DSM-5 and to evaluate the implications of these changes.
  
  
  METHODS
  The diagnostic criteria as well as the additional remarks provided in the running text of DSM-5 were carefully appraised.
  
  
  RESULTS
  For the first time diagnostic criteria are provided for disorders which up to now have been considered as subthreshold bipolar disorders. Furthermore, mixed episodes were eliminated and instead a mixed specifier was introduced. An increase in goal-directed activity/energy is now one of the obligatory symptoms for a (hypo)manic episode. Diagnostic guidance is provided as to when a (hypo)manic episode that has developed during treatment with an antidepressant has to be judged to be causally related to antidepressants and when this episode has only occurred coincidentally with antidepressant use.
  
  
  CONCLUSIONS
  While some of the novelties are clearly useful, e.g. addition of increased goal-directed activity/energy as obligatory symptom for (hypo)manic episodes, this remains to be demonstrated for others, such as the definition of various subthreshold bipolar disorders.
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
authors.forename: E
authors.initials: E
authors.lastname: Severus
authors.forename: M
authors.initials: M
authors.lastname: Bauer
mesh_terms: D001714:Bipolar Disorder / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D017408:Guidelines as Topic; D006801:Humans; D008370:Manuals as Topic / Q000592:standards*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011570:Psychiatry / Q000592:standards*; D014481:United States