An update will be provided on where development of DSM V is as of March, 2009. Two of the areas the DSM V Mood Disorders, Bipolar Subcommittee has focused on are 1) the boundaries between unipolar and bipolar disorder and 2) potentially better ways to handle the "not otherwise specified" category.
One of the areas of discussion is how the presence of hypomanic symptoms during a depressive episode in patients with unipolar illness should or should not be recognized. Does the presence of any hypomanic symptom(s) imply a given patient will develop well-defined bipolar disorder? What does research data suggest regarding hypomanic symptoms that differentiate "pure" unipolar versus "classic" bipolar disorder? The risks and possible benefits of making change will be discussed. The role of possible dimensional measures in DSM V will be considered.
A second important area of emphasis for the Mood Disorder Workgroup has been to refine and specify the content of bipolar presentations that do not meet criteria for bipolar disorder I or II, and are currently within the "not otherwise specified" category in DSM IV-TR. What is an appropriate threshold for identifying bipolar "spectrum" disorder currently labeled "not otherwise specified" category? In addition to these questions, the role dimensional measures may play in our future evaluation of mood disorders will be discussed.