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Bipolar and Related Disorders

Terms in this set (16)

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

B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:

1. Inflated self-esteem or grandiosity
2. decreased need for sleep (e.g.) feels rested after only 3 hours of sleep).
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility
6. Increase in goal-directed activity (socially, at work or school, or sexually) or psychomotor agitation (e.g. purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.

D. The disturbance in mood and the change in functioning are observable by others

E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. (If there are psychotic features, the episode is by definition manic).

F. The episode is not attributable to the psychological effects of a substance
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.

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)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional)
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The episode is not attributable to the psychological effects of a substance or another medical condition.

D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorders etc.

E. There has NEVER been a manic or hypomanic episode.
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of mess, start to improve within a few days after the onset of menses, and become minimal or absent in the week of post-menses.

B. One (ore more) of the following symptoms must be present:
1. Marked affective lability (e.g. mood swings; feeling suddenly sad or tearful, or increased sensitivity to rejection).
2. Marked irritability or anger or increased interpersonal conflicts.
3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts
4. Marked anxiety, tension, and/or feelings of being keyed up or on edge.

C. One (or more) of the following symptoms must additionally be present to reach a total of five symptoms when combined with symptoms from Criterion B above.
1. Decreased interest in usual activities (e.g. work, school, friends, hobbies)
2. Subjective difficulty in concentration.
3. Lethargy, easy fatality, or marked lack of energy
4. Marked change in appetite; overeating; or specific food cravings
5. Hypersomnia or insomnia
6. A sense of being overwhelmed or out of control.
7. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of "bloating" or weight gain.

D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others.

E. The disturbance is not merely an exacerbation of the symptoms of other disorders.

F. Criterion A should be confirmed by prospective daily ratings during at least two cycles.

G. The symptoms are not attributable to substance abuse.