B
ipolar disorders often are first
diagnosed in adolescence or early
adulthood after several years of
symptoms. Symptoms include
periods of mania, hypomania, psychosis, or
depression interspersed with periods of relative
wellness. The clinical course of bipolar
disorders varies. Patients rarely experience
a single episode, with relapse rates reported
at more than 70 percent over five years.1
Although bipolar disorders are defined by
the presence of manic or hypomanic symptoms,
most patients are depressed most of
the time, which is also a major source of
disability.2
Bipolar disorders include four subtypes:
bipolar I, bipolar II, cyclothymia, and bipolar
disorder not otherwise specified (Table 1).
3
Criteria for mood episodes involved in
diagnosing bipolar disorders are defined in
Table 2.
3
Each subtype can be divided using
specifiers, such as description of the patient’s
current or most recent episode. The rapidcycling
specifier can be applied to bipolar I or
II disorder if the patient has had at least four
mood episodes in the previous 12 months,
and the episodes were demarcated by partial
or full remission for at least two months or a
switch to an episode of opposite polarity (e.g.,
major depressive episode to manic episode).3