Bipolar and Related Disorder: Substance/Medication-Induced Bipolar

Question 1

What is substance/medication inducsed bipolar?

Answer 1

• alcohol or other substances (intoxication or withdrawal) can cause manic or hypomanic symptoms; these need not meet criteria for any of the conditions above

Question 2

How many criterias are set for substance/medication inducsed bipolar?

Answer 2

5 (A-E)

Question 3

What is Criteria A?

Answer 3

A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by elevated, expansive, or irritable mood, with or without depressed mood, or markedly diminished interest or pleasure in all, or almost all, activities.

Question 4

What is Criteria B?

Answer 4

There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):

The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.

The involved substance/medication is capable of producing the symptoms in Criterion A.

Question 5

What is Criteria C?

Answer 5

disturbance is not explained by

• a bipolar or related disorder that is not substance/medication-induced
• Such evidence of an independent bipolar or related disorder could include the following:
  
  • symptoms precede the onset of the substance/medication use;
  • the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or
  • there is other evidence suggesting the existence of an independent non-substance/medication-induced bipolar and related disorder (e.g., a history of recurrent non-substance/medication-related episodes)

Question 6

What is Criteria D?

Answer 6

disturbance does not occur exclusively during the course of a delirium

Question 7

What is Criteria E?

Answer 7

disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

Question 8

What are the features of substance/medication-induced bipolar?

Answer 8

are essentially the same as those for mania, hypomania, or depression

Question 9

How do you distinguish a substance/medication-induced bipolar from bipolar I diagnosis?

Answer 9

• full manic episode
• emerges during antidepressant treatment
• persists at full level beyond the physiological effect of treatment

Question 10

How do you distinguish a substance/medication-induced bipolar from bipolar II diagnosis?

Answer 10

• full hypomanic episode
• emerges during antidepressant treatment
• persists at full level beyond the physiological effect of treatment
• preceded by a major depressive episode

Question 11

What are the specifiers for Substance/Medication-Induced Bipolar?

Answer 11

Specify if:

• With onset during intoxication: If the criteria are met for intoxication with the substance and the symptoms develop during intoxication.
• With onset during withdrawal: If criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, withdrawal.

Question 12

How should the diagnosis be recorded?

Answer 12

[specific substance/medication]-induced bipolar and related disorders

mild, moderate, or severe [specific substance/medicaiton] use disorder

example

• mild cocaine use disorder with cocaine-induced bipolar and related disorder

Question 13

What are the specific substances/medication?

Answer 13

• alcohol
• phencycidine
• other hallucinogen
• sedative, hypnotic, or anxiolytic
• amphetamine (or other stimulant)
• cocaine
• other (or unknown) substance