Biopolar Preload (Behavior)

What are the types of bipolar disorders

Bipolar I disorder

Bipolar II disorder

Cyclothymic disorder

Substance/Medication-Induced bipolar and related d/o

Bipolar and related d/o due to another medical condition

Other specified bipolar and related d/o

Unspecified bipolar and related d/o

Criteria (DSM-5-TR) for Manic Epsiode

A. Period of abnormally and persistent elevated, expansive, or irritable mood and increased goal-directed activities or energy for at least 1 week, most of the day, nearly every day, or any duration if hospitalized

B. During disturbance, 3 or more of the following (4 if only A is irritable mood)

1. Inflated self-esteem or grandiosity

2. Decreased need for sleep

3. More talkative than usual or pressure to keep talking

4. Flight of ideas or subjective experience that thoughts are racing

5. Distractability (reported or observed)

6. Increase in goal-directed activity

7. Excessive involvement in activities that have a high potential for painful consequences

C. 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

D. Not attributable to physiologic effects of a substance or other medical condition

Criteria (DSM-5-TR) of Hypomanic Episode

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

B. During disturbance, 3 or more of the following (4 if only A is irritable mood)

1. Inflated self-esteem or grandiosity

2. Decreased need for sleep

3. More talkative than usual or pressure to keep talking

4. Flight of ideas or subjective experience that thoughts are racing

5. Distractability (reported or observed)

6. Increase in goal-directed activity

7. Excessive involvement in activities that have a high potential for painful consequences

C. Associated with unequivocal change in functioning that is uncharacteristic of individual when not symptomatic

D. Disturbance in mood and function is observable by others

E. The episode is NOT severe enough to cause marked impairment in social/occupational areas or to necessitate hospitalization. If psychotic features present, the episode is manic by definition.

F. The episode is not attributable to the physiological effects of a substance or other medical condition

Criteria (DSM5TR) for Major Depressive Episode

A. 5 or more of the following for the same 2 week period and change from previous functioning. Must include with (1) or (2)

1. Depressed mood most of the day, nearly every day

2. Markedly diminished interest/pleasure in all or almost all activities most of the day, nearly every day

   Significant weight change (5% or more)

   Insomnia or hypersomnia nearly every day

   Psychomotor agitation or retardation nearly every day

   Fatigue or loss of energy nearly every day

   Feelings of worthlessness or excessive guilt nearly every day

   Diminished ability to think or concentratenearly every day

   Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide

B. These symptoms cause clinically significant distress or impairment in important areas of functioning.

C. The episode is not attributable to the physiological effects of substance or another medical conditions

Criteria for Bipolar I Disorder

A. At least one manic episode

B. Occurance of manic and major depressive is not better explained by schizoaffective, schizophrenia, schizophreniform, delusional disorder, or other schizophrenia/psychotic disorders

Criteria for Bipolar II Disorder

A. met one hypomanic episode + one major depressive episode

B. never been manic

C. not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder

D. frequent alternation between periods of depression and hypomania causes clinically significant distress or impairment

What are the specifiers of Bipolar I/II

With rapid cycling

With mixed features

Criteria for Bipolar I/II wit rapid cycling

4 mood episodes in 12 months

Must be separated with full remission or switch to opposite polarity

Criteria for Bipolar I/II with mixed features

Multiple depressive symptoms while in a manic or hypomanic episode

Multiple symptoms of mania/hypomania while in a major depressive episode

Criteria for Cyclothymic Disorders

A. For at least 2 years, has hypomanic symptoms without meeting hypomanic episode and depressive symptoms without meeting MDE criteria

B. Symptoms present at least half the time during the 2 years and has not been without symptoms for 2 months

C. Does not meet criteria for MDD, manic episode, or hypomanic episode

Symptoms not better explained by schizophrenia spectrum or psychotic disorders

E. Not from substance or other medical condition

F. Causes clinically significant distress or impairment

Criteria for Substance/Medication-Induced Bipolar and Related Disorder

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 interested or pleasure in all, or almost all, activities.

B. Evidence of both (1) and (2)

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

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

C. not better explained by a bipolar or related disorder that is not substance/medication induced

D. does not occur exclusively during course of delirium

E. causes clinically significant distress/impairment