Bipolar I disorder

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.^{[citation needed]}

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, a drug of 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. In addition, the episodes are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified.

General diagnosis codes DSM-IV-TR

Treatment

Investigations

Routine investigations including HIV test, Full blood count, Thyroid function tests, Liver function test, Urea and Creatinine & if patient on Lithium, Lithium level. Drug screen including Cannaboids.

Bio-Psycho-Social

Biological

Mood Stabilizers

1. Lithium Carbonate - mainstay in the management of Bipolar, but it has a very narrow therapeutic safety. Thus requires monitoring.
2. Anticonvulsants such as Sodium Valproate, Carbamazepine or Lamotrigine.
3. Antipsychotics such as Quetiapine, Risperidone, Olanzapine or Aripiprazole
4. Electro-convulsive therapy as a treatment of last resort.

It should be emphasized that Anti-depressants should not be used in the treatment of Bipolar as it may precipitate a Manic episode.

Patient Education

Information on the condition, importance of regular sleep patterns, routines and eating habits & the importance of compliance with medication as prescribed.

Behavior modification - Advise them on the adverse effects of their behavior during the manic phase such as unprotected sex and wild spending.

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

Resources

International Society for Bipolar Disorders
National Bipolar Foundation [1]

External links

• Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 1994 (DSM-IV).
• Bipolar Mothers
• The Symptoms of Bipolar I disorder as described by a sufferer of Bipolar I
• Advice for Bipolar Disorder Sufferers and Their Loved Ones.
• "Manic Depression: Voices of an Illness" and The Infinite Mind public radio series

References

• American Psychiatric Association, 1400 K Street NW, Suite 1101, Washington, DC 20005-2403 USA.

• BipolarSupportAlliance.org
• United Nations Principles of Medical Ethics
• World Health Organization, CH-1211, Geneva 27, Switzerland, 1992