psychiatric disorders
Bipolar Disorders
Diagnosis of Bipolar Disorders
Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision criteria Thyroxine (T4) and thyroid-stimulating hormone (TSH) level to screen for hyperthyroidism Exclusion of stimulant abuse clinically or by blood or urine toxicology screening Routine laboratory tests (eg, complete blood cell count, basic metabolic panel) to rule out other general medical conditions requires meeting the DSM-5-TR criteria for a Mania as described above, plus a history of remission and relapse ( requires meeting the DSM-5-TR criteria for at least one hypomanic episode as well as at least one major depressive episode [ Diagnosis references ]). The symptoms must be severe enough to markedly impair social or occupational functioning or to require hospitalization to prevent harm to self or others. Some patients who present with depressive symptoms may have previously experienced hypomania or mania but do not report it unless they are specifically questioned. Skillful questioning may reveal morbid signs (eg, excesses in spending, impulsive sexual escapades, stimulant abuse), although such information is more likely to be provided by relatives. A structured inventory such as theMood Disorder Questionnairemay be useful. All patients must be asked gently but directly about suicidal ideation, plans, or activity. agonists, or general medical disorders such as Hyperthyroidism or A review of substance use (especially of Amphetamines and Some patients with Schizoaffective Disorder have manic symptoms, but such patients have psychotic features that may persist beyond the abnormal mood episodes. Patients with bipolar disorder may also have anxiety disorders (eg, Social Anxiety Disorder , 1.Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC, pp 140-151. 2.Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC, pp 151-160. 