Bipolar I disorder  

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Bipolar I disorder is a mood disorder that is characterized by at least one manic or mixed episode. There may be episodes of hypomania or major depression as well. It is a sub-diagnosis of bipolar disorder, and conforms to the classic concept of manic-depressive illness.

DSM-IV-TR diagnostic criteria

The essential feature of bipolar I disorder is a clinical course that is characterized by the occurrence of one or more manic episodes or mixed episodes. Often individuals have also had one or more major depressive episodes. Episodes of substance-induced mood disorder due to the direct effects of a medication, or other somatic treatments for depression, drug abuse, or toxin exposure, or of mood disorder due to a general medical condition need to be excluded before a diagnosis of bipolar I disorder can be made. In addition, the episodes must not be better accounted for by schizoaffective disorder or superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or a psychotic disorder not otherwise specified.

General diagnosis codes DSM-IV-TR

Treatment

Medical assessment

Routine medical assessments are often prescribed to rule-out or identify a somatic cause for bipolar I symptoms. These tests can include ultrasounds of the head, x-ray computed tomography (CAT scan), electroencephalogram, HIV test, full blood count, thyroid function test, liver function test, urea and creatinine levels and if patient is on lithium, lithium levels are taken. Drug screening includes recreational drugs, particularly cannabinoids, and exposure to toxins.

Medication

Mood stabilizers

1. Lithium carbonate, the mainstay in the management of bipolar disorder, but it has a narrow therapeutic range and typically requires monitoring
2. Anticonvulsants, such as sodium valproate, carbamazepine or lamotrigine
3. Antipsychotics, such as quetiapine, risperidone, olanzapine or aripiprazole
4. Electroconvulsive therapy, a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect

Some antidepressants have been found to precipitate a manic episode.

Patient education

Information on the condition, importance of regular sleep patterns, routines and eating habits and the importance of compliance with medication as prescribed. Behavior modification through counselling can have positive influence to help reduce the effects of risky behavior during the manic phase.

ICD-10 diagnostic criteria

• F31 Bipolar Affective Disorder
• F31.6 Bipolar Affective Disorder, Current Episode Mixed
• F30 Manic Episode
• F30.0 Hypomania
• F30.1 Mania Without Psychotic Symptoms
• F30.2 Mania With Psychotic Symptoms
• F32 Depressive Episode
• F32.0 Mild Depressive Episode
• F32.1 Moderate Depressive Episode
• F32.2 Severe Depressive Episode Without Psychotic Symptoms
• F32.3 Severe Depressive Episode With Psychotic Symptoms

See also

• Bipolar disorder
• Bipolar disorders research
• Bipolar II disorder
• Bipolar NOS
• Bipolar spectrum
• Borderline personality disorder
• Creativity and bipolar disorder
• Detailed listing of DSM-IV-TR bipolar disorder diagnostics codes
• Emotional dysregulation
• International Society for Bipolar Disorders
• List of people believed to have been affected by bipolar disorder
• Oppositional defiance disorder
• Seasonal affective disorder