DSM-IV Definitions
Reference:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, American Psychiatric Association, Washington,
D.C., 1994.
Bipolar Disorder is a mental illness characterized by the
presence of one or more of the following:
Only one of these episodes needs to occur just once during
the lifetime of an individual in order for that individual
to be considered as suffering from Bipolar Disorder.
The presence of a Major Depressive
Episode is very common in the lifetime of individuals with Bipolar Disorder
(more 90% of these individuals have at least one Major Depressive Disorder in
their lifetime), but it is not necessary. There are individuals with Bipolar
Disorder who do not have a history of Major Depressive Episodes in their lifetime.
Subtypes of Bipolar Disorder
Bipolar I Disorder
To be diagnosed as Bipolar I, an individual must have at least
one manic or mixed
episode (lasting for at least a week) within his or her
lifetime. A depressive
episode is not required in order to warrant a dianosis
of Bipolar I, although most people usually have multiple depressive
episodes.
Bipolar II Disorder
In order to receive a diagnosis of Bipolar II Disorder, one must
have had at least one hypomanic
episode and at least one depressive
episode within his or her lifetime. The patient must have never had
a manic episode.
Cyclothymic Disorder
To be diagnosed with Cyclothymic Disorder, one must have experienced,
over a period of two years (one year for children and adolescents),
numerous periods of time with hypomanic symptoms as well as
periods of depressive symptoms that do not meet the
criteria for Major
Depressive Episode. More than half of the days need to be either
high or low, and all periods of wellness need to last for less
than 2 months. The person must never have had a manic
episode.
"Bipolar
III"
This
is not a DSM-IV diagnosis, but it is a useful concept.
In our clinic, this diagnosis is used for a person
who has recurrent
Major Depressive Episodes and has never had an elevated mood
episode. This person does, however, have a parent, child
or sibling that meets criteria for Bipolar I Disorder,
Bipolar II Disorder,
or Cyclothymia.
Rapid-cycling Specifier
This is not a diagnosis but rather a course specifier
(other
course specifiers include seasonal and post-partum onset). A
person is rapid-cycling if he or she has at least 4 episodes
of mood disturbance within 12 months. Each mood disturbance must
meet criteria for a Major
Depressive, Manic, Mixed,
or Hypomanic
Episode.
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