Bipolar I disorder diagnostic criteria
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
Overview
Bipolar I disorder is a mood disorder that is characterized by at least one manic or mixed episode. There may be episodes of hypomania or major depression as well. It is a sub-diagnosis of bipolar disorder, and conforms to the classic concept of manic-depressive illness.[citation needed]
Differential Diagnosis
- Attention-deficit/hyperactivity disorder
- Disorders with prominent irritability
- Generalized anxiety disorder, panic disorder, post traumatic stress disorder, or other anxiety disorders
- Major depressive disorder
- Other bipolar disorders
- Personality disorders
- Substance/medication-induced bipolar disorder[1]
Epidemiology and Demography
Prevalence
The 12-month prevalence of bipolar disorder type I is 600 per 100,000 (0.6%) of the overall population.[1]
Risk Factors
- Divorced individual
- Genetic Predisposition
- High-income countries
- Separated individual
- widowed individual[1]
Diagnostic Criteria
For a diagnosis of bipolar I disorder, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes.
DSM-V Diagnostic Criteria for Manic Episode[1]
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least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary). AND
AND
AND
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Note:A full manic 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 manic episode and,therefore, a bipolar I diagnosis .
Note:Criteria A-D constitute a manic episode. At least one lifetime manic episode is required for the diagnosis of bipolar I disorder .
DSM-V Diagnostic Criteria for Hypomanic Episode[1]
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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 .
Note:Criteria A-'F constitute a hypomanic episode. Hypomanic episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder
.
DSM-V Diagnostic Criteria for Major Depressive Disorder[1]
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Note: Do not include symptoms that are clearly attributable to another medical condition.
:*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.)
:*9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. AND
AND
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Note:Criteria A-C constitute a major depressive episode. Major depressive episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder.
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 also 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 .
General diagnosis codes DSM-IV-TR
| Dx Code # | Disorder | Description |
|---|---|---|
| 296.0x | Bipolar I disorder | Single manic episode |
| 296.40 | Bipolar I disorder | Most recent episode hypomanic |
| 296.4x | Bipolar I disorder | Most recent episode manic |
| 296.6x | Bipolar I disorder | Most recent episode mixed |
| 296.5x | Bipolar I disorder | Most recent episode depressed |
| 296.7 | Bipolar I disorder | Most recent episode unspecified |
See also
- Bipolar disorder
- Bipolar II
- Detailed listing of DSM-IV-TR bipolar disorder diagnostics codes
- Borderline personality disorder
- Bipolar spectrum
- Seasonal affective disorder
- Oppositional defiance disorder
- Emotional dysregulation
- Creativity and bipolar disorder
- Bipolar disorders research
Resources
International Society for Bipolar Disorders