DSM-IV-TR Criteria for Manic Episode DSM-IV-TR Criteria for Manic Episode

 A distinct period of abnormally and A distinct period of abnormally and persistently elevated, expansive, or persistently elevated, expansive, or irritable mood, lasting at least 1 week (or irritable mood, lasting at least 1 week (or any duration if hospitalization is any duration if hospitalization is necessary). necessary).

 During the period of mood disturbance, During the period of mood disturbance, three (or more) of the following three (or more) of the following symptoms have persisted (four if the symptoms have persisted (four if the mood is only irritable) and have been mood is only irritable) and have been present to a significant degree: present to a significant degree:

– inflated self-esteem or grandiosity inflated self-esteem or grandiosity

– decreased need for sleep (e.g., feels rested decreased need for sleep (e.g., feels rested after only 3 hours of sleep) after only 3 hours of sleep)

– more talkative than usual or pressure to keep more talkative than usual or pressure to keep

– distractibility (i.e., attention too easily drawn to distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) unimportant or irrelevant external stimuli)

– increase in goal-directed activity (either socially, increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor at work or school, or sexually) or psychomotor agitation agitation

– excessive involvement in pleasurable activities excessive involvement in pleasurable activities that have a high potential for painful that have a high potential for painful consequences (e.g., engaging in unrestrained consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish buying sprees, sexual indiscretions, or foolish business investments) business investments)

 The symptoms do not meet criteria for a The symptoms do not meet criteria for a mixed episode. mixed episode.

 The mood disturbance is sufficiently severe The mood disturbance is sufficiently severe to cause marked impairment in to cause marked impairment in occupational functioning or in usual social occupational functioning or in usual social activities or relationships with others, or to activities or relationships with others, or to necessitate hospitalization to prevent harm necessitate hospitalization to prevent harm to self or others, or there are psychotic to self or others, or there are psychotic

 The symptoms are not due to the direct The symptoms are not due to the direct physiological effects of a substance (e.g., physiological effects of a substance (e.g., a drug of abuse, a medication, or other a drug of abuse, a medication, or other treatment) or a general medical condition treatment) or a general medical condition (e.g., hyperthyroidism). (e.g., hyperthyroidism).

Note: Note: Manic-like episodes that are clearly Manic-like episodes that are clearly caused by somatic antidepressant caused by somatic antidepressant treatment (e.g., medication, treatment (e.g., medication, electroconvulsive therapy, light therapy) electroconvulsive therapy, light therapy) should not count toward a diagnosis of should not count toward a diagnosis of bipolar I disorder. bipolar I disorder.

 (From American Psychiatric Association. (From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Diagnostic and Statistical Manual of Mental Disorders Disorders. 4th ed. Text rev. Washington, . 4th ed. Text rev. Washington, DC: American Psychiatric Association DC: American Psychiatric Association