DSM-5 Criteria for Bipolar Disorder
Assesses criteria for Bipolar I and Bipolar II disorders based on history of manic, hypomanic, and major depressive episodes.
Manic Episode
Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy
Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
More talkative than usual or pressure to keep talking
Flight of ideas or subjective experience that thoughts are racing
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
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)
Episode lasted at least 1 week (or any duration if hospitalization was necessary)
Mood disturbance caused marked impairment in social or occupational functioning or necessitated hospitalization to prevent harm to self or others, or there are psychotic features
Episode is not attributable to the physiological effects of a substance or another medical condition
Hypomanic Episode
Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy
Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
More talkative than usual or pressure to keep talking
Flight of ideas or subjective experience that thoughts are racing
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
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)
Episode lasted at least 4 consecutive days and was present most of the day, nearly every day
The episode represents a noticeable change from the person's baseline
The episode is not associated with marked impairment in social or occupational functioning
Episode is not attributable to the physiological effects of a substance or another medical condition
Major Depressive Episode
Depressed mood most of the day, nearly every day
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
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
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day (observable by others; not merely subjective feelings of restlessness or being slowed down)
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
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
Symptoms present during at least 2 weeks and represent a change from previous functioning
Symptoms represent a change from previous functioning
Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
Episode is not attributable to the physiological effects of a substance or another medical condition
Negative
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Instructions
Use the DSM-5 criteria to evaluate the presence of manic, hypomanic, and depressive episodes. Assess symptom duration, severity, and functional impact before confirming a diagnosis.
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