General Description
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
There are four types of Bipolar Disorders. They are Bipolar I Disorder (296.xx), Bipolar II Disorder (296.89), Cyclothymic Disorder (301.13), and Bipolar Disorder Not Otherwise Specified (296.80). Under Bipolar I Disorder there are six separate criteria sets. They are Bipolar I Disorder, Single Manic Episode (296.0x), Bipolar I Disorder, Most Recent Episode Hypomanic (296.40), Bipolar I Disorder, Most Recent Episode Manic (269.4x), Bipolar I Disorder, Most Recent Episode Mixed (296.6x), Bipolar I Disorder, Most Recent Episode Depressed (296.5x) and Bipolar I Disorder, Most Recent Episode Unspecified (296.7).
Persons with a Bipolar Disorder experience significant mood changes typically alternating between depression and mania/hypomania (irritable or elated mood). These mood changes are more severe and last longer than the normal variations that are considered normal.
Diagnostic Criteria
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
An individual may be considered to have some type of Bipolar I Disorder (296.xx) if they:
- Had a Manic Episode without a Major Depressive Episode (Single Manic 296.0x)
- Are having or recently had a Hypomanic Episode and had a Manic Episode or Mixed Episode in the past. (Most Recent Episode Hypomanic 296.40)
- Are having or recently had a Manic Episode and had a least one Major Depressive Episode, Manic Episode, or Mixed Episode in the past. (Most Recent Episode Manic 294.4x)
- Currently in a mixed Episode and had a least one Major Depressive Episode, Manic Episode, or Mixed Episode. (Most Recent Episode Mixed 296.6x)
- Are having or recently had a Major Depressive Episode and had at least one Manic or Mixed Episode. (Most Recent Depressed Episode 296.5x)
- Are having or recently had at least a Manic, Hypomanic, Mixed, or Major Depressive Episode and had a least one Manic or Mixed Episode. (Most Recent Episode Unspecified 296.7)
- Along with one of the above six symptoms the episodes must not be able to be justified by another mental disorder, medical condition, or substance. Also a diagnosis could be possible if the symptoms above cause problems in social, work, and other important setting of the individual's life.
An individual may be considered to have Bipolar II Disorder (296.xx) if the following symptoms are seen.
- Are having or have had at least one Major Depressive Episode.
- Are having or have had at least Hypomanic Episode.
- The individual has never had a Manic Episode or Mixed Episode.
- The symptoms can not be justified by another mental disorder.
- The symptoms cause stress in social, work, and other important areas of the individual life.
An individual may be considered to have Cyclothymic Disorder (301.13) if the following symptoms are seen.
- For a least two years or one year in children there have been many periods of hypomanic and depressive symptoms that don't meet the criteria for a Major Depressive Episode.
- During the 2-year or 1-year period of a child the person may have gone without symptoms that are mentioned in criteria 1 for more than two months.
- There is no Major Depressive, Manic, or Mixed Episode present during the first 2 years of diagnoses or 1 year of diagnoses for a child. If there is then Bipolar Disorder I and II can also be diagnosed.
- The symptoms in 1 are not better justified by another mental disorder, medical condition, or substance.
- The symptoms cause obvious stress in social, work, and other important aspects of life.
An individual may be considered to have Bipolar Disorder Not Otherwise Specified (296.8) if the following symptoms are seen.
- An individual does not meet the criteria for any specific Bipolar Disorder, but has similar symptoms. Such as very rapid alterations that would be classified as manic and depressive symptoms if they lasted the duration of time that is required for a diagnosis of Bipolar Disorder.
Etiology
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
First-degrees biological relatives of individuals with any Bipolar Disorder have a higher rate of a Bipolar Disorder. Also twins and adoption studies prove that Bipolar Disorder is largely influence by genetics.
Prevalence
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
Bipolar disorder (formerly known as manic depressive disorder) affects about 1% of Americans at some point in their lifetime. Men and women are about equally at risk.
EBP Treatment Approaches
Listed below are either evidence-based practices or promising practices that have been successful at treating Bipolar Disorders.
Psychosocial Treatments
- No consistent studies on psychosocial treatments with children
Pharmacological Treatments
(Click on Medications)
References
Geller, B; Luby, J. (1997, Sept.). Child and adolescent Bipolar Disorder: a review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry. 36(9):1168-1176.
Note - Full text is available through the University at Buffalo Libraries.
Links
APA Practice Guideline
Expert Consensus Guideline
Practice Guideline Clearing House
Diagnosis, Treatment, Research Gateway
Depression and Bipolar Support Alliance
National Alliance for the Mentally Ill
Dual Diagnosis Advocacy Group
Bipolar Disorders Information Center
Pendulum Resources on Bipolar Affective Disorder, Manic Depression
Bipolar Disorder Sanctuary
Harvard Bipolar Research Program
Harbor of Refuge: Bipolar Disorder/Manic-Depression Support
Child & Adolescent Bipolar Foundation (CABF)
Yahoo's Bipolar Disorder (Manic Depression) Links
Organization for Bipolar Affective Disorders Society
Bipolar Disorder - About.com
Bipolar Significant Other (BPSO)
Fact Sheets
Fact Sheets from the American Academy of Child and Adolescent Psychiatry
Note - Click on topic. (Please note disclaimer).
The AACAP developed Facts for Families to provide concise and up-to-date information on issues that affect children, teenagers, and their families.
The AACAP website includes facts, statistics, and overviews of different problems children and adolescents face and different mental health disorders that affect children and adolescents.
Fact Sheets from the National Institute of Mental Health
Note - Click on "select a topic".
NIMH offers a variety of publications and other educational resources to help people with mental health disorders, the general public, mental health and health care practitioners, and researchers gain a better understanding of mental illnesses and the research programs of the NIMH.
This website includes facts, statistics, pamphlets, checklists, and overviews of mental health disorders.
Fact Sheets from the National Mental Health Association
Note - Click on topic.
The NMHA offers answers to frequently asked questions, facts, statistics and overviews about different mental health disorders, as well as information about treatments and other problems that affect children and adolescents.
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