The DSM IV: Major Diagnostic Criteria
DSM-IV Diagnostic Criteria For Bipolar II Disorder
- One or more major depressive episodes and at
least one hypomanic episode
- Mood episodes cannot be due to a medical
condition, medication, drugs of abuse, toxins or
treatment for depression.
- Symptoms cannot be accounted for by a psychotic
Clinical Features of Bipolar II Disorder
- Hypomanic episodes tend to occur in close proximity to depressive episodes.
- Episodes occur more frequently with age.
- Social and occupational consequences of Bipolar II can be severe (e.g. job loss and divorce).
- These patients have a suicide rate of 10-15%
- Common co-morbid diagnoses includes substance-related disorders, eating disorders, attention deficit hyperactivity disorder, borderline personality disorder.
- Rapid cycling pattern carries a poor prognosis.
- The lifetime prevalence of bipolar II is 0.5%
- Possibly more common in women.
Classification of Bipolar II Disorder
- Classification of bipolar II disorder involve, describing the current or most recent mood episode which can be Hypomanic, or Depressive.
- The most recent episode can be further classified as follows
- Episodes without Psychotic Features.
- Episodes with Psychotic Features.
- Episodes with Catatonic Features.
- Episodes with Post partum Onset.
Bipolar II Disorder with Rapid Cycling
- Diagnosis requires the presence of at least 4 mood episodes within 1 year.
- Episodes may include major depressive, manic, hypomanic or mixed.
- The patient must be symptom-free for at least 2 months between episodes or the patient must display a change in mood to an opposite type of episode.
Differential Diagnosis of Bipolar II Disorder
- Cyclothymic Disorder: Mood episodes never meet criteria for full manic episode or full major depressive episode.
- Substance - Induced Mood Disorder: Rule out the effects of medication, drugs of abuse, toxin exposure.
- Mood Disorder Due to a General Medical Condition.
Treatment of Bipolar II Disorder
- The treatment of Bipolar II disorder involves lithium and/or anticonvulsants, and is similar to the treatment of in Bipolar I Disorder.