Bipolar and related syndromes

Question 1

Manic episode, criteria A

Answer 1

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).

Question 2

Manic episode, criteria B (7)

Answer 2

B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:

1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

Question 3

Manic episode, criteria C

Answer 3

C. The mood disturbance is sufficiently severe to cause marked impairment in social

or occupational functioning or to necessitate hospitalization to prevent harm to self

or others, or there are psychotic features.

Question 4

Hypomanic episode, criteria A

Answer 4

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.

Question 5

Hypomanic episode, criteria B

Answer 5

B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:

1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

Question 6

Hypomanic episode, criteria C

Answer 6

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.

Question 7

Hypomanic episode, criteria D

Answer 7

D. The disturbance in mood and the change in functioning are observable by others.

Question 8

Hypomanic episode, criteria E

Answer 8

E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization.

If there are psychotic features, the episode is, by definition, manic.

Question 9

Bipolar I syndrome, criteria A + note

Answer 9

A. Criteria have been met for at least one manic episode

note: depressive episodes are very common, but not necessary to diagnose the syndrome

Question 10

Bipolar II syndrome, criteria A

Answer 10

A. Criteria have been met for at least one hypomanic episode and at least one major depressive episode

Question 11

Specifier ‘with psychotic features’ + what syndromes can it be given with (2)

Answer 11

With psychotic features: Delusions or hallucinations are present at any time in the current manic or major depressive episode in bipolar I disorder (or the most recent manic or major depressive episode if bipolar I disorder is currently in partial or full remission) or in the current major depressive episode in bipolar II disorder (or the most recent major depressive episode if bipolar II disorder is currently in partial or full remission).

Can be given with Bipolar or Depressive syndromes