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Manic symptoms can occur in association with known organic disorders, but in such cases should be diagnosed as a mood disorder due to a general medical condition (ie, “secondary mania”) rather than as bipolar disorder. There appear to be no
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One essential criterion for a diagnosis of bipolar I disorder is a past or present history of a manic episode. Manic episodes are characterized by a predominantly elevated, expansive, or irritable mood that presents as a prominent or persistent part
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Women who wish to have a baby should have at least 2 yr of maintenance therapy with no episodes before a lithium holiday is prescribed. Lithium is discontinued in the 1st trimester to avoid the risk of Ebstein’s anomaly, a
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Acute management: Classic euphoric mania often presents as a social emergency and is preferably managed on an inpatient basis. Lithium works best in uncomplicated euphoric mania. After baseline laboratory tests (CBC, urinalysis, thyroxine, TSH, serum electrolytes, creatinine, and BUN) are
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Prevention of rapid cycling: Antidepressants may induce rapid cycling in some patients (eg, patients with bipolar II disorder and a cyclothymic temperament), even when given with lithium. The best strategy is preventive: limiting the use of antidepressants during the depressive
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Symptoms of the depressive phase are similar to those of unipolar depression (see above), except that psychomotor retardation, hypersomnia, and, in extreme cases, stupor are more characteristic. In full-blown manic psychosis, the mood is usually elation, but irritability and frank
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Major Depressive, Manic, Mixed, and Hypomanic Episodes in Bipolar I Disorder must be distinguished from episodes of a Mood Disorder Due to a General Medical Condition. The diagnosis is Mood Disorder Due to a General Medical Condition for episodes that
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Thorough evaluation of many persons with depression reveals bipolar traits, and as many as one in five patients with a depressive disorder also develops frank hypomania or mania. Most switches from unipolar to bipolar disorder occur within 5 yr of
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There are no reports of differential incidence of Bipolar I Disorder based on race or ethnicity. There is some evidence that clinicians may have a tendency to overdiagnose Schizophrenia (instead of Bipolar Disorder) in some ethnic groups and in younger
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The lifetime prevalence of Bipolar I Disorder in community samples has varied from 0.4% to 1.6%. Course Average age at onset is 20 for both men and women. Bipolar I Disorder is a recurrent disorder – more than 90% of
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The essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic Episodes or Mixed Episodes. Often individuals have also had one or more Major Depressive Episodes. Episodes of Substance-Induced
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If the full criteria are currently met for a Manic, Mixed, or Major Depressive Episode, the following specifiers may be used to describe the current clinical status of the episode and to describe features of the current episode: Mild, Moderate,
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