Bipolar II disorder diagnostic criteria: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Attention-deficit/hyperactivity disorder | *[[Attention-deficit/hyperactivity disorder]] | ||
*[[Cyclothymic disorder]] | *[[Cyclothymic disorder]] | ||
*[[Major depressive disorder]] | *[[Major depressive disorder]] | ||
*Other bipolar disorders | *Other [[bipolar disorders]] | ||
*[[Panic disorder]] or other [[anxiety disorders]] | *[[Panic disorder]] or other [[anxiety disorders]] | ||
*[[Personality disorders]] | *[[Personality disorders]] | ||
Revision as of 15:44, 20 October 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
Overview
Bipolar II Disorder is a bipolar spectrum disorder that is characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes are more frequent and more intense than manic episodes. It is believed to be underdiagnosed because hypomanic behavior often presents as high-functioning.[citation needed]
Differential Diagnosis
- Attention-deficit/hyperactivity disorder
- Cyclothymic disorder
- Major depressive disorder
- Other bipolar disorders
- Panic disorder or other anxiety disorders
- Personality disorders
- Schizophrenia spectrum and other related psychotic disorders
- Substance use disorders[1]
Epidemiology and Demographics
Prevalence
The 12 month prevalence of bipolar II disorder is 800 per 100,000 (0.8%) of the overall population.[1]
Risk Factors
- Genetic predisposition[1]
Natural History,Complications,and Prognosis
Prognosis
Good prognostic factors include:
- More education
- Fewer years of illness
- Married
Poor prognostic factors include:
- Rapid-cycling pattern
Diagnostic Criteria
DSM-V Diagnostic Criteria for Bipolar II Disorder[1]
| “ |
For a diagnosis of bipolar II disorder, it is necessary to meet the following criteria for a current or past hypomanic episode and the following criteria for a current or past major depressive episode: Hypomanic Episode
AND
AND
AND
AND
episode is, by definition, manic. AND
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” |
Note:A full hypomanic episode that emerges during antidepressant treatment (e.g.,medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a hypomanic episode diagnosis. However, caution is indicated so that one or two symptoms (particularly increased irritability, edginess, or agitation following antidepressant use) are not taken as sufficient for diagnosis of a hypomanic episode, nor necessarily indicative of a bipolar diathesis. .
Major Depressive Episode
- A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms
is either (1 ) depressed mood or (2) loss of interest or pleasure.
Note:Do not include symptoms that are clearly attributable to a medical condition.
- 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g.,
appears tearful). (Note: In children and adolescents, can be irritable mood.)
- 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
- 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every
day.(Note:In children, consider failure to make expected weight gain.)
- 4. Insomnia or hypersomnia nearly every day.
- 5. Psychomotor agitation or retardation nearly every day (observable by others; not merely subjective feelings of restlessness or being slowed down).
- 6. Fatigue or loss of energy nearly every day.
- 7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
- 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, a suicide attempt, or a specific plan for committing suicide.
AND
B. The symptoms cause clinically significant distress or impairment in social, occupational,or other important areas of functioning.
AND
C. The episode is not attributable to the physiological effects of a substance or another medical condition. }}
Note:Criteria A-C above constitute a major depressive episode.
Note:Responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss noted in Criterion A, which may resemble a depressive episode. Although such symptoms may be understandable or considered appropriate to the loss, the presence of a major depressive episode in addition to the normal response to a significant loss should be carefully considered. This decision inevitably requires the exercise of clinical judgment based on the individual’s history and the cultural norms for the expression of distress in the context of loss.
Specifiers
- Chronic
- With Catatonic features
- With Melancholic features
- With atypical features
- With Postpartum onset
- Longitudinal course specifiers (with and without interepisode recovery)
- With seasonal pattern (applies only to the pattern of Major Depressive Episodes)
- With Rapid Cycling
See also
- Bipolar Disorder
- Bipolar I
- Detailed listing of DSM-IV-TR Bipolar Disorder diagnostics codes
- Bipolar spectrum
- Emotional dysregulation
- Creativity and bipolar disorder
- Bipolar disorders research
- Temporal Lobe Epilepsy