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INTRODUCTION

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  • Bipolar disorder is a common, lifelong, often severe cyclic mood disorder characterized by recurrent fluctuations in mood, energy, and behavior. The mania or hypomania is neither substance-related nor caused by any other medical condition or psychiatric disorder.

    • ✓ Bipolar I disorder: At least one manic episode, which may have been preceded by and may be followed by hypomanic or major depressive episode(s).

    • ✓ Bipolar II disorder: At least one hypomanic episode and a current or past major depressive episode.

  • Cyclothymic disorder: Chronic fluctuations between subsyndromal depressive and hypomanic episodes.

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PATHOPHYSIOLOGY

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  • Medical conditions, medications, and treatments that may induce mania are shown in Table 67–1.

  • Bipolar disorder is influenced by developmental, genetic, neurobiological, and psychological factors. Probably multiple gene loci are involved in heredity.

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Table Graphic Jump Location
TABLE 67–1Secondary Causes of Mania
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CLINICAL PRESENTATION

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  • Different types of episodes may occur sequentially with or without a period of normal mood (euthymia) between. There can be mood fluctuations that continue for months or after one episode, there can be years without recurrence of any type of mood episode (Table 67–2).

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Table Graphic Jump Location
TABLE 67–2abEvaluation and Diagnosis of Mood Episodes

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