What Are Specifiers?

Question: What Are Specifiers?

Answer: Specifiers are extensions to a diagnosis that further clarify the course, severity, or special features of a disorder or illness. The Diagnostic & Statistical Manual of Mental Disorders (DSM-IV) uses these extensively in the diagnosis of mood disorders. For bipolar disorder, there are two categories - those for defining the current or most recent episode and those concerning the course of recurrent (repeating) episodes.

The specifiers from the DSM-IV include:

1. Current or Most Recent Episode - manic, mixed, or major depressive
   • Severity/Psychotic/Remission
     • Mild
     • Moderate
     • Severe without Psychotic Features
     • Severe with Psychotic Features
       • Mood Congruent
       • Mood Incongruent
     • In Partial Remission
     • In Full Remission
   • Chronic
   • Catatonic Features
   • Melancholic Features
   • Atypical Features
   • Postpartum Disorder

2. Course of Recurrent Episodes
   • Longitudinal (over a long period of time)
   • Seasonal Pattern
   • Rapid Cycling

References:
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR™).

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