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Bipolar Disorder, Mixed

Manic episode of predominantly elevated mood or irritable mood. During this mania, had at least 3 of the following (4 if the mood was only irritable):

  • Inflated self-esteem or grandiosity
  • Decreased need for sleep (insomnia)
  • More talkative than usual or pressured speech
  • Flight of ideas or racing thoughts
  • Distractibility
  • Increased activity or agitation
  • Reckless involvement in pleasurable activities

Evidence that this mania caused marked occupational or social impairment

Absence of two weeks or more of delusions or hallucinations when mood was normal

Not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified

Absence of evidence that an organic factor initiated or maintained this mania

Current (or most recent) episode involves the full symptomatic picture of both Manic and Major Depressive Episodes. During this superimposed depression:

  • Persistent depressed mood
  • Marked apathy or loss of interest
  • Significant anorexia or weight loss or increase in appetite or weight
  • Insomnia or hypersomnia
  • Psychomotor agitation or psychomotor retardation
  • Fatigue
  • Feelings of worthlessness or excessive guilt
  • Poor concentration or indecisiveness
  • Recurrent thoughts of death or suicide
  • Absence of evidence that an organic factor initiated and maintained this depression
  • Absence of evidence that this depression was due to normal bereavement
  • Absence of two weeks or more of delusions or hallucinations when mood was normal

Bipolar Disorder, Manic

Manic period of predominantly elevated mood or irritable mood. During this mania, had at least 3 of the following (4 if the mood was only irritable):

  • Inflated self-esteem or grandiosity
  • Decreased need for sleep (insomnia)
  • More talkative than usual or pressured speech
  • Flight of ideas or racing thoughts
  • Distractibility
  • Increased activity or agitation
  • Reckless involvement in pleasurable activities

Evidence that this mania caused marked occupational or social impairment

Absence of two weeks or more of delusions or hallucinations when mood was normal

Not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified

Absence of evidence that an organic factor initiated and maintained this mania

Bipolar Disorder, Depressed

Past history of manic period of predominantly elevated mood or irritable mood. During this mania, had at least 3 of the following (4 if the mood was only irritable):

  • Inflated self-esteem or grandiosity during this mania
  • Decreased need for sleep during this mania (insomnia)
  • More talkative than usual or pressured speech during this mania
  • Flight of ideas or racing thoughts during this mania
  • Distractibility during this mania
  • Increased activity or agitation during this mania
  • Reckless involvement in pleasurable activities during this mania

Evidence that this mania caused marked occupational or social impairment

Absence of evidence that an organic factor initiated or maintained this mania

Currently (or most recently) in a major depressive episode. During this major depressive episode had at least 5 of the following:

  • Persistent depressed mood
  • Marked apathy or loss of interest
  • Significant anorexia or weight loss or increase in appetite or weight
  • Insomnia or hypersomnia
  • Psychomotor agitation or psychomotor retardation
  • Fatigue
  • Feelings of worthlessness or excessive guilt
  • Poor concentration or indecisiveness
  • Recurrent thoughts of death or suicide

Absence of evidence that an organic factor initiated or maintained this depression

Absence of evidence that this depression was due to normal bereavement

Absence of two weeks or more of delusions or hallucinations when mood was normal not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified

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