A. The hypomanic symptoms and depressive symptoms have persisted for at least 2 years (at least a year in children and adolescents) without meeting the criteria for hypomanic episodes and major depressive episodes.

B. Criterion A symptoms have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.

C. Criteria for a major depressive, manic, or hypomanic episode have never been found.

D. Schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorders cannot be used to explain the symptoms in Criterion A.

E. The symptoms are not ascribed to the physiological effects of a substance or another medical condition.  

F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 


[DSM-5-TR] Diagnostic Criteria of Cyclothymic Disorder

The lifetime prevalence of cyclothymic disorder in the United States and Europe is approximately 0.4%–2.5%. Prevalence in mood disorders clinics may range from 3% to 5%.

Cyclothymic disorder is equally common in males and females in the general population. In clinical settings, females who have cyclothymic disorder may be more likely to receive treatment than males.


Prevalence of Cyclothymic Disorder

The cyclothymic disorder usually begins in adolescence or early adult life and is sometimes considered to reflect a moody tendency to other disorders.

There is a 15%– 50% risk that an individual with cyclothymic disorder will subsequently develop bipolar I disorder or bipolar II disorder; Youth have higher diagnostic conversion rates than adults. 


Development and Course of Cyclothymic Disorder

Risks and Prognostic Factors that may affect a diagnosis of Cyclothymic Disorder include:

- Genetic and physiological


Risk and Prognostic Factors of Cyclothymic Disorder

Differential diagnoses to Cyclothymic Disorder include:

- Bipolar and Related Disorder Due to Another Medical Condition

- Substance/Medication-Induced Bipolar and Related Disorder and Substance/Medication-Induced Depressive Disorder

- Bipolar I Disorder, With Rapid Cycling and Bipolar II Disorder, With Rapid Cycling

- Borderline Personality Disorder


Differential Diagnoses to Cyclothymic Disorder

Substance-related disorders and sleep disorders may be present in individuals with cyclothymic disorders.
In outpatient psychiatric settings, rates of comorbid psychiatric disorders in children with cyclothymic disorder are similar to children who have bipolar I or II disorder and greater than those with disruptive behavior/attention-deficit/hyperactivity disorder.


Comorbidity of Cyclothymic Disorder

This includes the intersection of connections and/or research related to Cyclothymic Disorder in other fields of study and research. Such fields include:
- Clinical Psychology
- Health Psychology


Interdisciplinary Connections and Research Related to Cyclothymic Disorder

Cyclothymic Disorder is defined by the presence of both hypomanic and depressive symptoms without fulfilling the criteria for a distinct episode of mania, hypomania, or major depression. These symptoms must persist for over two years (or one year for children & adolescents).

Syracuse University

The DSM-5-TR separates Bipolar and Related Disorders into the following specific disorders:
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
- Substance/Medication-Induced Bipolar and Related Disorder
- Bipolar and Related Disorder Due to Another Medical Condition
- Other Specified Bipolar and Related Disorder
- Unspecified Bipolar and Related Disorder
- Unspecified Mood Disorder


[DSM-5-TR] List of Bipolar and Related Disorders

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

Bipolar I Disorder is distinguished by the experience of a fully syndromal manic episode or manic symptoms that are severe enough to require immediate hospitalization at least once within the patient’s lifetime. Usually the patient will experience depressive episodes or symptoms as well, typically qualifying for a major depressive episode, though not always. Episodes of depression with mixed features (i.e.., having depressive and manic symptoms at the same time) are also possible. 

Bipolar I Disorder

Cyclothymic Disorder

Bipolar II Disorder is defined by the occurrence of at least one major depressive episode and at least one hypomanic episode. A key diagnostic requirement is that the patient must have no history of a full manic episode. The combination of major depressive symptoms and resulting mood instability typically causes significant impairment in the individual's daily functioning.

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