Bipolar I disorder
Encyclopedia
Bipolar I disorder is a mood disorder
that is characterized by at least one manic or mixed episode. There may be episodes of hypomania
or major depression
as well. It is a sub-diagnosis
of bipolar disorder
, and conforms to the classic concept of manic-depressive illness.
s. Episodes of substance-induced mood disorder due to the direct effects of a medication
, or other somatic
treatments for depression, drug abuse
, or toxin
exposure, or of mood disorder due to a general medical condition need to be excluded before a diagnosis of bipolar I disorder can be made. In addition, the episodes must not be better accounted for by schizoaffective disorder
or superimposed on schizophrenia
, schizophreniform disorder
, delusional disorder
, or a psychotic disorder not otherwise specified.
s of the head, x-ray computed tomography (CAT scan), electroencephalogram, HIV test
, full blood count, thyroid function test, liver function test, urea
and creatinine
levels and if patient is on lithium
, lithium levels are taken. Drug screening includes recreational drugs, particularly cannabinoids, and exposure to toxins.
s
Some antidepressant
s have been found to precipitate a manic episode.
patterns, routines and eating habits and the importance of compliance with medication as prescribed
. Behavior modification
through counselling
can have positive influence to help reduce the effects of risky behavior during the manic phase.
Mood disorder
Mood disorder is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature...
that is characterized by at least one manic or mixed episode. There may be episodes of hypomania
Hypomania
Hypomania is a mood state characterized by persistent and pervasive elevated or irritable mood, as well as thoughts and behaviors that are consistent with such a mood state...
or major depression
Major depressive episode
A major depressive episode is the cluster of symptoms of major depressive disorder. The description has been formalised in psychiatric diagnostic criteria such as the DSM-IV and ICD-10, and is characterized by severe, highly persistent depression, and a loss of interest or pleasure in everyday...
as well. It is a sub-diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
of bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
, and conforms to the classic concept of manic-depressive illness.
DSM-IV-TR diagnostic criteria
The essential feature of bipolar I disorder is a clinical course that is characterized by the occurrence of one or more manic episodes or mixed episodes. Often individuals have also had one or more major depressive episodeMajor depressive episode
A major depressive episode is the cluster of symptoms of major depressive disorder. The description has been formalised in psychiatric diagnostic criteria such as the DSM-IV and ICD-10, and is characterized by severe, highly persistent depression, and a loss of interest or pleasure in everyday...
s. Episodes of substance-induced mood disorder due to the direct effects of a medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
, or other somatic
Somatic Psychology
Somatic psychology is an interdisciplinary field involving the study of the body, somatic experience, and the embodied self, including therapeutic and holistic approaches to body. The word somatic comes from the ancient Greek somat . The word psychology comes from the ancient Greek psyche and logia...
treatments for depression, drug abuse
Drug abuse
Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts...
, or toxin
Toxin
A toxin is a poisonous substance produced within living cells or organisms; man-made substances created by artificial processes are thus excluded...
exposure, or of mood disorder due to a general medical condition need to be excluded before a diagnosis of bipolar I disorder can be made. In addition, the episodes must not be better accounted for by schizoaffective disorder
Schizoaffective disorder
Schizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception.Schizoaffective disorder...
or superimposed on schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
, schizophreniform disorder
Schizophreniform disorder
Schizophreniform disorder is a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of the time within a one-month period, but signs of disruption are not present for the full six months required for the diagnosis of schizophrenia.The symptoms of both...
, delusional disorder
Delusional disorder
Delusional disorder is an uncommon psychiatric condition in which patients present with circumscribed symptoms of non-bizarre delusions, but with the absence of prominent hallucinations and no thought disorder, mood disorder, or significant flattening of affect...
, or a psychotic disorder not otherwise specified.
General diagnosis codes DSM-IV-TR
| Dx Code # | Disorder | Description |
|---|---|---|
| 296.0x | Bipolar I disorder | Single manic episode. |
| 296.40 | Bipolar I disorder | Most recent episode hypomanic |
| 296.4x | Bipolar I disorder | Most recent episode manic |
| 296.6x | Bipolar I disorder | Most recent episode mixed |
| 296.5x | Bipolar I disorder | Most recent episode depressed |
| 296.7 | Bipolar I disorder | Most recent episode unspecified |
Medical assessment
Routine medical assessments are often prescribed to rule-out or identify a somatic cause for bipolar I symptoms. These tests can include ultrasoundUltrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
s of the head, x-ray computed tomography (CAT scan), electroencephalogram, HIV test
HIV test
HIV tests are used to detect the presence of the human immunodeficiency virus , the virus that causes acquired immunodeficiency syndrome , in serum, saliva, or urine. Such tests may detect antibodies, antigens, or RNA.- Terminology :...
, full blood count, thyroid function test, liver function test, urea
Urea
Urea or carbamide is an organic compound with the chemical formula CO2. The molecule has two —NH2 groups joined by a carbonyl functional group....
and creatinine
Creatinine
Creatinine is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body...
levels and if patient is on lithium
Lithium
Lithium is a soft, silver-white metal that belongs to the alkali metal group of chemical elements. It is represented by the symbol Li, and it has the atomic number 3. Under standard conditions it is the lightest metal and the least dense solid element. Like all alkali metals, lithium is highly...
, lithium levels are taken. Drug screening includes recreational drugs, particularly cannabinoids, and exposure to toxins.
Medication
Mood stabilizerMood stabilizer
A mood stabilizer is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar disorder.-Uses:...
s
- Lithium carbonateLithium carbonateLithium carbonate is a chemical compound of lithium, carbon, and oxygen with the formula Li2CO3. This colorless salt is widely used in the processing of metal oxides and has received attention for its use in psychiatry. It is found in nature as the rare mineral zabuyelite.-Properties:Like almost...
, the mainstay in the management of bipolar disorder, but it has a narrow therapeutic range and typically requires monitoring - AnticonvulsantAnticonvulsantThe anticonvulsants are a diverse group of pharmaceuticals used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder, since many seem to act as mood stabilizers, and in the treatment of neuropathic pain. The goal of an...
s, such as sodium valproateSodium valproateSodium valproate or valproate sodium is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy, anorexia nervosa, panic attack, anxiety disorder, posttraumatic stress disorder, migraine and bipolar disorder, as well as other psychiatric conditions requiring...
, carbamazepineCarbamazepineCarbamazepine is an anticonvulsant and mood-stabilizing drug used primarily in the treatment of epilepsy and bipolar disorder, as well as trigeminal neuralgia...
or lamotrigineLamotrigineLamotrigine, marketed in the US and most of Europe as Lamictal by GlaxoSmithKline, is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. It is also used as an adjunct in treating depression, though this is considered off-label usage... - AntipsychoticAntipsychoticAn antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis , particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s...
s, such as quetiapineQuetiapineQuetiapine , is an atypical antipsychotic approved for the treatment of schizophrenia, and bipolar disorder....
, risperidoneRisperidoneRisperidone is a second generation or atypical antipsychotic, sold under the trade name . It is used to treat schizophrenia , schizoaffective disorder, the mixed and manic states associated with bipolar disorder, and irritability in people with autism...
, olanzapineOlanzapineOlanzapine is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder...
or aripiprazoleAripiprazoleAripiprazole is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression... - Electroconvulsive therapyElectroconvulsive therapyElectroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
, a psychiatric treatment in which seizureSeizureAn epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
s are electrically induced in anesthetized patients for therapeutic effectTherapeutic effectA therapeutic effect is a consequence of a medical treatment of any kind, the results of which are judged to be desirable and beneficial. This is true whether the result was expected, unexpected, or even an unintended consequence of the treatment...
Some antidepressant
Antidepressant
An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes people with a depressive illness will experience a therapeutic effect to their mood;...
s have been found to precipitate a manic episode.
Patient education
Information on the condition, importance of regular sleepSleep
Sleep is a naturally recurring state characterized by reduced or absent consciousness, relatively suspended sensory activity, and inactivity of nearly all voluntary muscles. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli, and is more easily reversible than...
patterns, routines and eating habits and the importance of compliance with medication as prescribed
Medical prescription
A prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist....
. Behavior modification
Behavior modification
Behavior modification is the use of empirically demonstrated behavior change techniques to increase or decrease the frequency of behaviors, such as altering an individual's behaviors and reactions to stimuli through positive and negative reinforcement of adaptive behavior and/or the reduction of...
through counselling
Mental Health Counselor
Mental health counselors practice mental health counseling which is a dynamic, holistic, strengths-based and psychoeducational discipline born in the late 1970s when several mental health professionals realized that the master’s degree level counselors working in community settings lacked a...
can have positive influence to help reduce the effects of risky behavior during the manic phase.
ICD-10 diagnostic criteria
- F31 Bipolar Affective Disorder
- F31.6 Bipolar Affective Disorder, Current Episode Mixed
- F30 Manic Episode
- F30.0 Hypomania
- F30.1 Mania Without Psychotic Symptoms
- F30.2 Mania With Psychotic Symptoms
- F32 Depressive Episode
- F32.0 Mild Depressive Episode
- F32.1 Moderate Depressive Episode
- F32.2 Severe Depressive Episode Without Psychotic Symptoms
- F32.3 Severe Depressive Episode With Psychotic Symptoms
See also
- Bipolar disorderBipolar disorderBipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
- Bipolar disorders researchBipolar disorders research-Heritability or inheritance of the illness:More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression, indicating that the disease has a genetic component. Studies seeking to identify the genetic basis of bipolar...
- Bipolar II disorderBipolar II disorderBipolar II disorder is a bipolar spectrum disorder characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes can be more frequent and are more intense than hypomanic episodes...
- Bipolar NOSBipolar NOSBipolar disorder NOS is a diagnosis for bipolar disorder when it does not fall within the other established sub-types Sub-types of bipolar are part of the bipolar spectrum. Bipolar NOS is described as drastic changes in mood, it is considered a mood disorder.This disorder usually occurs during...
- Bipolar spectrumBipolar spectrumThe bipolar spectrum refers to a category of mood disorders that feature abnormally elevated or depressed mood. These disorders range from bipolar I disorder, featuring full-blown manic episodes, to cyclothymia, featuring less prominent hypomanic episodes, to "subsyndromal" conditions where only...
- CyclothymiaCyclothymiaCyclothymia is a mood and mental disorder in the bipolar spectrum that causes both hypomanic and depressive episodes. It is defined medically within the bipolar spectrum and consists of recurrent disturbances between sudden hypomania and dysthymic episodes. The diagnosis of cyclothymic disorder is...
- Borderline personality disorderBorderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
- Creativity and bipolar disorderCreativity and bipolar disorderMental disorders and creativity are often considered to be related, particularly in pop psychology.There is anecdotal evidence for a relationship between creativity and psychosis, particularly schizophrenia. James Joyce had a daughter with schizophrenia and had many schizotypal traits. Albert...
- Detailed listing of DSM-IV-TR bipolar disorder diagnostics codes
- Emotional dysregulationEmotional dysregulationEmotional dysregulation is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response...
- International Society for Bipolar DisordersInternational Society for Bipolar DisordersThe International Society for Bipolar Disorders is a non-profit organization based in Pittsburgh, Pennsylvania, USA, where it was founded June 17, 1999 . The society focuses on research and education in bipolar disorders....
- List of people believed to have been affected by bipolar disorder
- Oppositional defiance disorder
- Seasonal affective disorderSeasonal affective disorderSeasonal affective disorder , also known as winter depression, winter blues, summer depression, summer blues, or seasonal depression, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or summer, spring or autumn...