Background Dysphoria – characterised by irritable tension, pervasive discontent and aversive emotionality – is a clinically significant yet nosologically ambiguous phenomenon. It remains marginalised in major diagnostic systems (DSM-5-TR, ICD-11), relegated to a symptomatic descriptor rather than a validated entity, perpetuating diagnostic imprecision and therapeutic risks. Aims This review argues for the formal recognition of dysphoria as a distinct transdiagnostic affective dimension. It synthesises evidence to demonstrate its neurobehavioural correlates, protean manifestations across disorders and the clinical imperative for its operationalisation within dimensional frameworks. Method We conducted a synthesis of evidence across neuropsychiatry, phenomenology and diagnostic research. Historical typologies (e.g. directionality (extrapunitive versus intrapunitive), temporality (paroxysmal versus chronic) and structural complexity) and contemporary dimensional models (e.g. RDoC’s Negative
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