Some of the most difficult questions in the field of psychiatry are those related to how we define when deviant behaviors are indicative of a mental disorder. The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) provides criteria for diagnosing mental disorders, but it is not always clear how to apply this information to real-world cases.

Here, I will briefly review some key points from DSM-5 that may be helpful in understanding when behavior might be symptomatic of a psychiatric illness. In DSM-IV, which was the previous edition of the manual, there were three diagnostic categories that pertained to mental disorders: schizophrenia spectrum and other psychotic disorders; bipolar disorder; and depressive disorders. In contrast, in DSM-V (2013), these are not considered “diagnoses” but rather dimensions of human behavior. There is also a fourth category for behavioral disturbances such as autism spectrum disorder or attention deficit hyperactivity disorder.

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In DSM-IV, individuals with these diagnoses were considered to have a mental disorder. In contrast, in the DSM-V (2013), they are not considered “diagnoses” but rather dimensions of human behavior. There is also a fourth category for behavioral disturbances such as autism spectrum disorder or attention deficit hyperactivity disorder.

How do you know when deviant behaviors indicate an underlying psychiatric illness?

It may be helpful to think about how often and in what setting(s) this type of behavior occurs, whether there is evidence that the person was aware of their actions at the time, and if there’s been any remorse expressed after doing so. These considerations can help clarify whether it might be more indicative of something like bipolar man.

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