Diagnosing bipolar disorders in DSM-5

Editorial A few weeks ago, after many years of intensive work, the much-awaited fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published. It is still the case today that psychiatric diagnoses seem to be more consensus-based than validity-based (Cuthbert and Insel 2013; Bschor et al. 2012; Berk 2013) something that DSM-5 will also be unable to change. In spite of this, DSM-5 introduces several important changes with regard to diagnostic criteria for bipolar disorders. The International Journal of Bipolar Disorders is honored that Jules Angst, whose work has made an outstanding contribution to the modifications regarding bipolar disorders in DSM-5 (Angst et al. 2011, 2012), has agreed to comment on the strengths, problems and perspectives relating to these changes in the paper that accompanies this editorial (Angst 2013). An essential topic thankfully addressed by Jules Angst in the accompanying paper (Angst 2013) has been hotly debated within the psychiatric scientific community throughout the last few years namely whether bipolar disorders are much more frequent than previously assumed. If this is the case, one may conclude that the hitherto existing diagnostic criteria have falsely prevented the proper diagnosis of all cases of bipolar disorders on account of their being overly restrictive. In DSM-5, bipolar and related disorders, as they are now called, are given a chapter on their own, between depressive disorders and schizophrenia spectrum disorders, that includes bipolar I disorder (which represents, according to DSM-5, classic manic depressive disorder, with the exception that neither a depressive episode nor psychosis has to be present for diagnosis), bipolar II disorder and cyclothymic disorder. Furthermore, in this chapter, there are now separate diagnostic criteria for