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Bipolar I Disorder, Most Recent Episode Manic Symptoms and DSM-IV Diagnosis

Bipolar I Disorder, Most Recent Episode Manic Symptoms and Diagnosis Overview:

Bipolar I Disorder, Most Recent Episode Manic symptoms and diagnostic criteria follow below. While some of these Bipolar I Disorder, Most Recent Episode Manic symptoms may be recognized by family, teachers, legal and medical professionals,  and others, only  properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. Many additional factors are considered in addition to the Bipolar I Disorder, Most Recent Episode Manic symptoms in making proper diagnosis, including frequently medical and psychological testing considerations. This information on Bipolar I Disorder, Most Recent Episode Manic symptoms and diagnostic criteria are for information purposes only and should never replace the judgment and comprehensive assessment of a trained mental health clinician. 


Diagnostic criteria for 296.4x Bipolar Disorder, Most Recent Episode Manic


A.    Currently (or most recently) in a Manic Episode (See Below)


B.    There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode


C.    The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.


Specify (for current or most recent episode):

     Severity/Psychotic/Remission Specifiers

     With Catatonic 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




Criteria for Manic Episode


A.    A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 weeks (or any duration if hospitalization is necessary).


B.    During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) 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 (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

(6)   increased in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation

(7)   excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)


C.    The symptoms do not meet criteria for Mixed Episode (see p. 335).


D.    The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.


E.    The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).


Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.


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