Dsm bipolar i12/17/2023 ![]() ![]() Used for suspicion (e.g., in emergency department)įor a diagnosis of bipolar I disorder, it is necessary to meet the following criteria for a manic episode. Substance-induced mania (include name of substance)Įxamples include steroids, alcohol, cocaine, or prescription antidepressants Mixed type, also known as mixed features, is a recent specifier that includes concurrent features of hypomania or mania and depression patients who do not meet full criteria for bipolar disorders remain categorized as having unipolar depression Hypomanic and depressive symptoms that do not meet bipolar II disorder criteria, no major depressive episodes, occurring over two years, with no more than two months free of symptomsīipolar disorder, not otherwise specifiedĭoes not meet criteria for major depression, bipolar I disorder, bipolar II disorder, or cyclothymia (e.g., less than one week of manic symptoms, without psychosis or hospitalization)īipolar disorder, mixed features type or major depressive disorder, mixed features type Hypomanic episode with major depression no history of mania, but can have a history of hypomania Manic or mixed feature episode with or without psychosis and/or major depression Lithium, quetiapine, or a combination of quetiapine and lithium or valproic acid is effective for maintenance of bipolar disorder. Lurasidone (Latuda) combined with lithium or valproic acid is an effective treatment for acute bipolar depression. ![]() Quetiapine and cariprazine (Vraylar) are effective single agents for the treatment of acute bipolar depression. 12Įffective combination therapies for acute mania include lithium or valproic acid with quetiapine (Seroquel) or risperidone (Risperdal). Lithium, valproic acid (Depakote), and some antipsychotics are effective single agents for acute mania. Systematic review of randomized controlled clinical trials regarding treatment generalized to screening Screen all patients 12 years and older for depression, including all pregnant patients in the perinatal period screening should be implemented with adequate systems in place to support accurate diagnosis, psychotherapy, and follow-up. Patients and their support systems should be educated about the chronic nature of this illness, possible relapse, suicidality, environmental triggers (e.g., seasonal light changes, shift work, other circadian disruption), and the effectiveness of early intervention to reduce complications. Psychotherapy is a useful adjunct to pharmacotherapy. Ongoing management involves monitoring for suicidal ideation, substance use disorders, treatment adherence, and recognizing medical complications of pharmacotherapy. Monotherapy with antidepressants is contraindicated during episodes with mixed features, manic episodes, and in bipolar I disorder. Active lifestyle approaches include good nutrition, exercise, sleep hygiene, and proper weight management. Pharmacotherapy with mood stabilizers, such as lithium, anticonvulsants, and antipsychotics, is a first-line treatment that should be continued indefinitely because of the risk of patient relapse. Physicians should consider bipolar disorder in any patient presenting with depression. ![]() New diagnostic criteria and specifiers with attention on mixed features and anxious distress aid the physician in recognizing episode severity and prognosis. Affected individuals have higher rates of other mental health disorders, substance use disorders, and comorbid chronic medical illnesses. Bipolar disorders are common, recurrent mental health conditions of variable severity that are difficult to diagnose. ![]()
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