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INTRODUCTION

ICD-10 Diagnostic Criteria

In the ICD-10, bipolar disorder (BP) is included under mood (affective) disorders, conditions in which the fundamental disturbance is a change in affect or mood to depression (with or without associated anxiety) or to elation. The mood change is usually accompanied by a change in the overall level of activity; most of the other symptoms are either secondary to, or easily understood in the context of, the change in mood and activity. Most of these disorders tend to be recurrent and the onset of individual episodes can often be related to stressful events or situations.

F30 Manic Episode

All the subdivisions of this category should be used only for a single episode. Hypomanic or manic episodes in individuals who have had one or more previous affective episodes (depressive, hypomanic, manic, or mixed) should be coded as bipolar affective disorder (F31.).

F30.0 Hypomania

A disorder characterized by a persistent mild elevation of mood, increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, over-familiarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection. Irritability, conceit, and boorish behavior may take the place of the more usual euphoric sociability. The disturbances of mood and behavior are not accompanied by hallucinations or delusions.

F30.1 Mania Without Psychotic Symptoms

Mood is elevated out of keeping with the patient's circumstances and may vary from carefree joviality to almost uncontrollable excitement. Elation is accompanied by increased energy, resulting in overactivity, pressure of speech, and a decreased need for sleep. Attention cannot be sustained, and there is often marked distractibility. Self-esteem is often inflated with grandiose ideas and overconfidence. Loss of normal social inhibitions may result in behavior that is reckless, foolhardy, or inappropriate to the circumstances, and out of character.

F30.2 Mania with Psychotic Symptoms

In addition to the clinical picture described in F30.1, delusions (usually grandiose) or hallucinations (usually of voices speaking directly to the patient) are present, or the excitement, excessive motor activity, and flight of ideas are so extreme that the subject is incomprehensible or inaccessible to ordinary communication. Subtypes: 1) mood-congruent psychotic symptoms; 2) mood-incongruent psychotic symptoms; and 3) manic stupor.

F30.8 Other Manic Episodes

F30.9 Manic Episode, Unspecified (Mania NOS)

Bipolar Affective Disorder (F31)

A disorder characterized by two or more episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). Repeated episodes of hypomania or mania only are classified as bipolar manic depression; manic-depressive (illness, psychosis, reaction): Excl.: bipolar disorder, single manic episode (F30), cyclothymia (F34.0).

F31.0 Bipolar Affective Disorder, Current Episode Hypomanic

The patient is currently hypomanic, and has had at least one ...

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