Bipolar disorder physical examination
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nuha Al-Howthi, MD[2]
Overview
- Physical examination of patients with bipolar disorder is usually normal.
Physical Examination
Bipolar disorder is characterized by periods depression that alternate with periods of mania. Physical examination of patients with bipolar disorder is usually normal. A mental status examination physical examination should assess patients for:[1]
- Major depression for 2 weeks being either a depressed mood or loss of pleasure, and presence of at least five of the following symptoms:
- Depressed mood
- Markedly diminished interest in nearly all activities
- marked weight loss or gain or significant loss or increase in appetite
- Hypersomnia or insomnia
- Psychomotor retardation or agitation
- Loss of energy or fatigue
- Feelings of worthlessness or excessive guilt
- Decreased concentration ability
- Preoccupation with death or suicide.
- Mania: feature at least 1 week of profound mood disturbance, characterized by elation, irritability, or expansiveness and at least 3 of the diagnostic criteria
- Grandiosity
- Diminished need for sleep
- Excessive talking
- Racing thoughts
- Clear evidence of distractibility
- Increased level of goal-focused activity at home, at work.
- Excessive pleasurable activities.
- Hypomania characterized by an elevated, or irritable mood of at least 4 consecutive days duration. for diagnosis it require at least three of the symptoms of mania.
- Impulsive or risk-taking behaviors
- Suicidal thoughts and behavior
- Risk factors for suicide attempts and deaths.
- In addition to current symptoms, it is important to ascertain the number, frequency, intensity, and duration of past mood episodes.
Examination using the Mental Status Examination as well as assessment of the following:
- Appearance
- Affect/mood
- Thought content
- Perception
- Suicide/self-destruction
- Homicide/violence/aggression
- Judgment/insight
- Cognition
- Physical health
References
- ↑ Work Group on Psychiatric Evaluation. American Psychiatric Association Steering Committee on Practice Guidlines (2006). "Psychiatric evaluation of adults. Second edition. American Psychiatric Association". Am J Psychiatry. 163 (6 Suppl): 3–36. PMID 16866240.