Hypomanic episodes are characterized by an elevated, expansive, or irritable mood of at least 4 consecutive days' duration. Hypomanic episodes are part of the criteria for diagnosing BPII. At least three of these symptoms are also present:
Grandiosity or inflated self-esteem
Diminished need for sleep
Pressured speech
Racing thoughts or flight of ideas
Clear evidence of distractibility
Increased level of goal-focused activity at home, at work, or sexually
Engaging in activities with a high potential for painful consequences
The diagnosis of BPI requires the presence of a manic episode of at least 1 week's duration or that leads to hospitalization or other significant impairment in occupational or social functioning. The episode of mania cannot be caused by another medical illness or by substance abuse. Manic episodes include at least 1 week of profound mood disturbance, characterized by elation, irritability, or expansiveness (referred to as gateway criteria). At least three of these symptoms must also be present:
Grandiosity
Diminished need for sleep
Excessive talking or pressured speech
Racing thoughts or flight of ideas
Clear evidence of distractibility
Increased level of goal-focused activity at home, at work, or sexually
Excessive pleasurable activities, often with painful consequences
Major depressive episodes are characterized as five or more of the following symptoms in the same 2 weeks, with at least one of the symptoms being either a depressed mood or loss of pleasure or interest:
Depressed mood
Markedly diminished pleasure or interest in nearly all activities
Significant weight loss or gain or significant loss or increase in appetite
Hypersomnia or insomnia
Psychomotor retardation or agitation
Loss of energy, or fatigue
Feelings of worthlessness or excessive guilt
Decreased concentration ability or marked indecisiveness
Preoccupation with death or suicide; patient has a plan or has attempted suicide
Mixed symptomatology is quite common in patients presenting with bipolar symptomatology. This often causes a diagnostic dilemma and has prompted a revision to the definition of bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). With the aim of capturing mixed symptoms more effectively, the "mixed episode" diagnosis has been eliminated in favor of a "mixed features specifier" that could be added to any mood bipolar disorder diagnosis. Other specifiers include anxious distress, rapid cycling, mood-congruent psychotic features, catatonia, peripartum onset, and seasonal pattern.
For more on the presentation of bipolar disorder, read here.
Medscape © 2018 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Fast Five Quiz: Are You Prepared to See Patients With Bipolar Disorder? - Medscape - Jun 22, 2018.
Comments