Other Proposed Changes to Criteria for Depression
In addition to the elimination of the "grief exclusion" for a diagnosis of major depression, the DSM-5 Work Group on Depressive Disorders is proposing these major changes:
Addition of premenstrual dysphoria as a separate diagnostic category: Previously an entry in the appendix to DSM-IV, an international team of researchers led by work group member Kim Yonkers, M.D., reviewed evidence and found that premenstrual dysphoria causes significant impairment in a small percentage of women, that it responds differentially to certain kinds of treatment, and that it follows a distinct course.
Elimination of "mixed states" as a category within bipolar disorder: In previous editions of DSM, "mixed state" referred to symptoms of mania and depression that occur at the same time. But current research indicates that symptoms of mania can be common in unipolar depression and that depressive disorders are on a spectrum. Thus, the work group proposes to include symptoms of mania as a specifier for all depressive disorders.
Inclusion of ratings for anxiety and suicide risk: Research indicates that a high level of anxiety predicts a poorer response to treatment and is a risk for suicide.
