Psychiatry & Psychology
Share
Tweet
Cite
approximately 14 views in the last month.
MANIC EPISODE: (NOTE: Criteria A through D constitute a manic episode. At least one lifetime manic episode is required for the diagnosis of bipolar I disorder.)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
[checkbox name="variable_1" value="Yes|No"] [text name="variable_1" default=""]

B. During the period of mood disturbance and increased energy or activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1) Inflated self-esteem or grandiosity. [checkbox name="variable_2" value="Yes|No"] [text name="variable_2" default=""]
2) Decreased need for sleep (eg, feels rested after only 3 hours of sleep). [checkbox name="variable_3" value="Yes|No"] [text name="variable_3" default=""]
3) More talkative than usual or pressure to keep talking. [checkbox name="variable_4" value="Yes|No"] [text name="variable_4" default=""]
4) Flight of ideas or subjective experience that thoughts are racing. [checkbox name="variable_5" value="Yes|No"] [text name="variable_5" default=""]
5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. [checkbox name="variable_6" value="Yes|No"] [text name="variable_6" default=""]
6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (ie, purposeless non-goal-directed activity). [checkbox name="variable_7" value="Yes|No"] [text name="variable_7" default=""]
7) Excessive involvement in activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). [checkbox name="variable_8" value="Yes|No"] [text name="variable_8" default=""]

C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. [checkbox name="variable_9" value="Yes|No"] [text name="variable_9" default=""]

D. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, other treatment) or to another medical condition. [checkbox name="variable_10" value="Yes|No"] [text name="variable_10" default=""]

HYPOMANIC EPISODE: (Criteria A through F constitute a hypomanic episode. Hypomanic episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder.)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. [checkbox name="variable_11" value="Yes|No"] [text name="variable_11" default=""]

B. During the period of mood disturbance and increased energy and activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
1) Inflated self-esteem or grandiosity. [checkbox name="variable_12" value="Yes|No"] [text name="variable_12" default=""]
2) Decreased need for sleep (eg, feels rested after only 3 hours of sleep). [checkbox name="variable_13" value="Yes|No"] [text name="variable_13" default=""]
3) More talkative than usual or pressure to keep talking. [checkbox name="variable_14" value="Yes|No"] [text name="variable_14" default=""]
4) Flight of ideas or subjective experience that thoughts are racing. [checkbox name="variable_15" value="Yes|No"] [text name="variable_15" default=""]
5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. [checkbox name="variable_16" value="Yes|No"] [text name="variable_16" default=""]
6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation. [checkbox name="variable_17" value="Yes|No"] [text name="variable_17" default=""]
7) Excessive involvement in activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). [checkbox name="variable_18" value="Yes|No"] [text name="variable_18" default=""]

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. [checkbox name="variable_19" value="Yes|No"] [text name="variable_19" default=""]

D. The disturbance in mood and the change in functioning are observable by others. [checkbox name="variable_20" value="Yes|No"] [text name="variable_20" default=""]

E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic. [checkbox name="variable_21" value="Yes|No"] [text name="variable_21" default=""]

F. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment). [checkbox name="variable_22" value="Yes|No"] [text name="variable_22" default=""]

BIPOLAR MAJOR DEPRESSION:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least 1 of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
NOTE: Do not include symptoms that are clearly attributable to another medical condition.
1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (eg, feels sad, empty, hopeless) or observations made by others (eg, appears tearful). (NOTE: In children and adolescents can be irritable mood.) [checkbox name="variable_23" value="Yes|No"] [text name="variable_23" default=""]
2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). [checkbox name="variable_24" value="Yes|No"] [text name="variable_24" default=""]
3) Significant weight loss when not dieting or weight gain (eg, a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. (NOTE: In children, consider failure to make expected weight gain.) [checkbox name="variable_25" value="Yes|No"] [text name="variable_25" default=""]
4) Insomnia or hypersomnia nearly every day. [checkbox name="variable_26" value="Yes|No"] [text name="variable_26" default=""]
5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). [checkbox name="variable_27" value="Yes|No"] [text name="variable_27" default=""]
6) Fatigue or loss of energy nearly every day. [checkbox name="variable_28" value="Yes|No"] [text name="variable_28" default=""]
7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). [checkbox name="variable_29" value="Yes|No"] [text name="variable_29" default=""]
8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by their subjective account or as observed by others). [checkbox name="variable_30" value="Yes|No"] [text name="variable_30" default=""]
9) 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. [checkbox name="variable_31" value="Yes|No"] [text name="variable_31" default=""]

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. [checkbox name="variable_32" value="Yes|No"] [text name="variable_32" default=""]

C. The episode is not attributable to the direct physiological effects of a substance or to another medical condition. [checkbox name="variable_33" value="Yes|No"] [text name="variable_33" default=""]

D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. [checkbox name="variable_34" value="Yes|No"] [text name="variable_34" default=""]
MANIC EPISODE: (NOTE: Criteria A through D constitute a manic episode. At least one lifetime manic episode is required for the diagnosis of bipolar I disorder.)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).


B. During the period of mood disturbance and increased energy or activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1) Inflated self-esteem or grandiosity.
2) Decreased need for sleep (eg, feels rested after only 3 hours of sleep).
3) More talkative than usual or pressure to keep talking.
4) Flight of ideas or subjective experience that thoughts are racing.
5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (ie, purposeless non-goal-directed activity).
7) Excessive involvement in activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

D. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, other treatment) or to another medical condition.

HYPOMANIC EPISODE: (Criteria A through F constitute a hypomanic episode. Hypomanic episodes are common in bipolar I disorder but are not required for the diagnosis of bipolar I disorder.)
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.

B. During the period of mood disturbance and increased energy and activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
1) Inflated self-esteem or grandiosity.
2) Decreased need for sleep (eg, feels rested after only 3 hours of sleep).
3) More talkative than usual or pressure to keep talking.
4) Flight of ideas or subjective experience that thoughts are racing.
5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
7) Excessive involvement in activities that have a high potential for painful consequences (eg, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.

D. The disturbance in mood and the change in functioning are observable by others.

E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.

F. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment).

BIPOLAR MAJOR DEPRESSION:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least 1 of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
NOTE: Do not include symptoms that are clearly attributable to another medical condition.
1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (eg, feels sad, empty, hopeless) or observations made by others (eg, appears tearful). (NOTE: In children and adolescents can be irritable mood.)
2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
3) Significant weight loss when not dieting or weight gain (eg, a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. (NOTE: In children, consider failure to make expected weight gain.)
4) Insomnia or hypersomnia nearly every day.
5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6) Fatigue or loss of energy nearly every day.
7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by their subjective account or as observed by others).
9) 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.

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The episode is not attributable to the direct physiological effects of a substance or to another medical condition.

D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

Result - Copy and paste this output:
Questions/General site feedback

Send Feedback for this SOAPnote

This site uses Akismet to reduce spam. Learn how your comment data is processed.

More SOAPnotes by this Author: