Severity/Psychotic/Remission Specifiers for Mixed Episode

DSM-IV-TR criteria

  • NOTE: code in fifth digit. Mild, Moderate, Severe Without Psychotic Features, and Severe With Psychotic Features can be applied only if the criteria are currently met for a Major Depressive Episode. In Partial Remission and In Full Remission can be applied to the most recent Major Depressive Episode in Major Depressive Disorder and to a Major Depressive Episode in Bipolar I Disorder only if it is the most recent type of mood episode.
  • .x1 — Mild: No more than minimum symptom criteria are met for both a Manic Episode and a Major Depressive Episode. Mildepisodes are characterized by the presence of only three or four manic symptoms and five or six depressive symptoms.
  • .x2 — Moderate: Symptoms or functional impairment between “mild” and “severe.” Moderateepisodes are characterized by an extreme increase in activity or impairment in judgment.
  • .x3 — Severe Without Psychotic Features: Almost continual supervision required to prevent physical harm to self or others. Episodes that are Severe Without Psychotic Featuresare characterized by the need for almost continual supervision to protect the individual from harm to self or others.”
  • .x4 — Severe With Psychotic Features: Delusions or hallucinations. If possible, specify whether the psychotic features are mood-congruent or mood-incongruent:
    • Mood-Congruent Psychotic Features: Delusions or hallucinations whose content is entirely consistent with the typical manic or depressive themes.
    • Mood-Incongruent Psychotic Features: Delusions or hallucinations whose content does not involve typical manic or depressive themes. Included are such symptoms as persecutory delusions (not directly related to grandiose or depressive themes), thought insertion, and delusions of being controlled.
  • .x5 — In Partial Remission: Symptoms of a Mixed Episode are present but full criteria are not met, or there is a period without any significant symptoms of a Mixed Episode lasting less than 2 months following the end of the Mixed Episode.
  • .x6 — In Full Remission: During the past 2 months, no significant signs or symptoms of the disturbance were present
  • .x0 — Unspecified.*

Associated features

Child vs. adult presentation

Gender and cultural differences in presentation

Epidemiology

Etiology

Empirically supported treatments