Reference · Assessment and Planning

DSM-5-TR durations and symptom counts

How to use this

Exam vignettes often hinge on a time window or a symptom count: two weeks versus two years, one month versus six. Read the vignette for how long and how many, then check the threshold here. Each row is our own summary, linked to a public source. It is a study aid, not the DSM. When you can spot the trap, test it on LCSW, LMSW or LBSW practice questions.

Search thresholds

Showing 1 to 10 of 37 thresholds

Depressive disorders

Disorder	Key threshold	Common exam trap
Major depressive disorder	Symptoms must be present together during the same 2-week period. Untreated episodes commonly last many months.NCBI Bookshelf (StatPearls)MSD Manual Professional NCBI Bookshelf (StatPearls)	Trap: Two weeks is the cutoff that separates an episode from ordinary sadness; adjustment disorder and bereavement are the comparison items.
Major depressive disorder	Five or more of nine symptoms are required, and at least one must be depressed mood or loss of interest/pleasure. The other symptoms are sleep, appetite/weight, psychomotor, fatigue, worthlessness/guilt, concentration, and recurrent thoughts of death.NCBI Bookshelf (StatPearls)MSD Manual Professional NCBI Bookshelf (StatPearls)	Trap: Four symptoms, or five without mood/anhedonia, falls short of MDD.
Persistent depressive disorder	At least 2 years in adults and 1 year in children and adolescents (mood may be irritable in youth).NCBI Bookshelf (StatPearls)MSD Manual Professional	Trap: 2 years adult vs 1 year child is a favorite number trap.
Persistent depressive disorder	Depressed mood plus at least two of six further symptoms: appetite change, sleep change, low energy, low self-esteem, poor concentration or indecision, hopelessness. Fewer symptoms than MDD requires.NCBI Bookshelf (StatPearls)	Trap: Only two accompanying symptoms needed, versus five total for MDD.

Bipolar and related disorders

Disorder	Key threshold	Common exam trap
Manic episode	A manic episode lasts at least 1 week, present most of the day nearly every day, or any length if hospitalization is needed. Mood is abnormally elevated, expansive or irritable, with increased energy or activity.MSD Manual Professional NCBI Bookshelf (StatPearls)	Trap: If hospitalization was needed, the episode counts as mania even if it lasted less than a week.
Hypomanic episode	A hypomanic episode lasts at least 4 consecutive days, present most of the day nearly every day. Others can see the change, but it does not cause marked impairment, need hospitalization, or include psychosis.NCBI Bookshelf (StatPearls)NCBI Bookshelf (StatPearls)	Trap: Four days is the hypomania threshold; any psychosis or hospitalization makes the episode mania.
Cyclothymic disorder	Many periods of hypomanic-type and depressive-type symptoms that never meet full episode criteria, lasting at least 2 years in adults and 1 year in children and adolescents, with symptoms present at least half the time and never absent over 2 months.NCBI Bookshelf (StatPearls)MSD Manual Professional	Trap: Chronic fluctuation below episode threshold; full manic or major depressive episode rules it out.

Schizophrenia spectrum and psychotic disorders

Disorder	Key threshold	Common exam trap
Schizophrenia	Continuous signs of disturbance for at least 6 months, including at least 1 month of active-phase symptoms (the remainder can be prodromal or residual). Impairment in work, relationships or self-care is required.NCBI Bookshelf (StatPearls)MSD Manual Professional	Trap: 1 month vs 6 months separates brief psychotic, schizophreniform and schizophrenia.
Schizophrenia	Two or more of five core symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms) in a 1-month active phase, at least one being delusions, hallucinations or disorganized speech. DSM-5 dropped the subtypes.NCBI Bookshelf (StatPearls)MSD Manual Professional	Trap: Subtypes (paranoid, etc.) no longer exist in DSM-5; and one bizarre delusion no longer suffices alone.
Schizophreniform disorder	Same symptom picture as schizophrenia but total duration of at least 1 month and under 6 months. Functional decline is not required. Provisional if diagnosed before recovery. Becomes schizophrenia if it persists past 6 months.MSD Manual Professional	Trap: The 1-to-6-month window is the whole point.

Sources

1.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK559078/
2.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders
3.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK558911/
4.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK541052/
5.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/mood-disorders/bipolar-disorders
6.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK558998/
7.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK539864/
8.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/schizophrenia
9.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/schizophreniform-disorder
10.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK539912/
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12.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK441870/
13.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/anxiety-and-trauma-and-stressor-related-disorders/generalized-anxiety-disorder
14.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK430973/
15.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/anxiety-and-trauma-and-stressor-related-disorders/panic-attacks-and-panic-disorder
16.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK554387/
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19.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK559129/
20.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK507832/
21.PubMed Central. pmc.ncbi.nlm.nih.gov/articles/PMC9077590/
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23.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK562178/
24.MSD Manual Professional. www.msdmanuals.com/professional/psychiatric-disorders/feeding-and-eating-disorders/bulimia-nervosa
25.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK532242/
26.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK526136/
27.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK538131/
28.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK553166/
29.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK441882/
30.MSD Manual Professional. www.msdmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/alcohol-toxicity-and-withdrawal
31.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK436003/
32.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK526012/
33.MSD Manual Professional. www.msdmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/opioid-toxicity-and-withdrawal
34.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK459239/
35.MSD Manual Professional. www.msdmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/anxiolytics-and-sedatives
36.MSD Manual Professional. www.msdmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/amphetamines
37.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK441838/
38.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK554371/
39.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK499958/
40.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK557443/

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