Individuals with attenuated psychosis syndrome often experience anxiety and/ or depres— sion. Some individuals with an attenuated psychosis syndrome diagnosis will progress to another diagnosis, including anxiety, depressive, bipolar, and personality disorders. In such cases, the psychopathology associated with the attenuated psychosis syndrome diagnosis is reconceptualized as the prodromal phase of another disorder, not a comorbid condition.
Lifetime experience of at least one major depressive episode meetlng the following criteria:
A. Five (or more) of the following criteria have been present during the same 2-week pe- riod and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. (Note: Do not include symptoms that are clearly attributable to a medical condition.) 1. Depressed mood most of the day, nearly every day. as indicated by either subjec- tive report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.) 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.) 4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delu- sional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (ei- ther by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation with- out a specific plan, or a suicide attempt or a specific plan for committing suicide.
. The symptoms cause clinically significant distress or impairment in social, occupa- tional, or other important areas of functioning.
. The disturbance is not attributable to the physiological effects of a substance or an- other medical condition.
. The disturbance is not better explained by schizoaffective disorder and is not superim- posed on schizophrenia, schizophreniform disorder, delusional disorder, or other spec- ified or unspecified schizophrenia spectrum and other psychotic disorder.
At least two lifetime episodes of hypomanic periods that involve the required crite- rion symptoms below but are of insufficient duration (at least 2 days but less than 4 consecutive days) to meet criteria for a hypomanic episode. The criterion symp- toms are as follows:
A.
B.
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goaI-directed activity or energy.
During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable), represent a no- ticeable change from usual behavior, and have been present to a significant degree:
Inﬂated seIt-esteem or grandiosity.
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
More talkative than usual or pressured to keep talking.
Flight of ideas or subjective experience that thoughts are racing.
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.