Bipolar Disorder – Diagnostic Interviewing for Manic Episode

Time to read: 2 minutes

DSM-5 Criteria for Bipolar Disorder

Bipolar disorder is a disturbance in mood that consists of patients moving between depression and hypomania or mania. A newer entity Bipolar depression, although not present in DSM-V is a valid entity that presents with predominantly depressed mood that lies along a bipolar trait. Following are the questions that will help you come closer to the diagnosis of Bipolar Disorder.

OPEN QUESTIONS

  • Have you ever had the opposite of depression, when you’ve been extremely happy, over the top, doing things out of character or talking too fast? (Elevated mood)
  • How long did it last for?  (in a borderline construct mood swings will be present over an extended period of time beginning from adolescence and pervading through adulthood)

GRANDIOSITY

  • During this period did/do you feel especially confident, like you were on top of the world?
  • How do/did you see yourself in comparison to others?
  • Did/do you feel you had special powers that others didn’t?
  • Did/do you feel a special connection with God?
  • Do you consider yourself special in any way?
  • Do you think God has a special purpose for you here?

 

FLIGHT OF IDEAS

  • Do you find your thoughts racing?
  • Do you find it difficult to keep track of your thoughts?
  • Do your thoughts jump from place to place that makes it difficult for you to keep track of them?

PRESSURE OF SPEECH

  • Do you find it hard to stop talking?
  • Have your friends/family commented on the way you are talking?
  • Have they said that they find it difficult to follow your speech?

SLEEP DEFICIT

  • Have you needed much less sleep than usual?
  • Do you feel like you can work all day without needing rest/sleep?

INCREASED GOAL DIRECTED ACTIVITY

  • Have you taken on any new activities lately?
  • Have you come across any brilliant ideas lately?

INDISCRETION / RECKLESSNESS

  • Have you been in trouble with the police or your family lately?
  • Have you been doing things that are out of character for you?

DIFFERENTIALS AND CO-MORBIDITIES

  • Schizoaffective Disorder – Criteria of Schizophrenia should be present
  • Personality Disorder – esp. Borderline Personality Disorder. Both can co-exist
  • Substance misuse – High degree of alcohol and drug misuse in Bipolar patients
  • ADHD
  • Drug-induced and ECT induced Mania

 

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