psychiatry

DSM-5 Criteria for Bipolar Disorder

DSM-5 diagnostic criteria checklist for Bipolar I (manic episode required) and Bipolar II (hypomanic + depressive episode required) disorders. Distinguishing features of mania vs hypomania are duration and impairment.

Abnormally and persistently elevated, expansive, or irritable mood*

Abnormally increased goal-directed activity or energy during the same period*

Inflated self-esteem or grandiosity*

Decreased need for sleep (feels rested after only 3 hours)*

More talkative than usual or pressure to keep talking*

Flight of ideas or subjective experience that thoughts are racing*

Distractibility (attention too easily drawn to unimportant stimuli)*

Increase in goal-directed activity OR psychomotor agitation OR reckless behaviour (spending, sexual, business)*

Episode duration*

Marked impairment OR psychotic features OR hospitalisation required (distinguishes mania from hypomania)*

Score interpretation

Criteria Not Met 0–4

Insufficient criteria for bipolar disorder

→ Consider cyclothymia, ADHD, substance use, personality disorder, thyroid disease; MDQ screening; monitor longitudinally

Bipolar Features Present 5–12

Significant manic/hypomanic symptoms — bipolar disorder likely

→ Urgent psychiatry referral; mood stabiliser (lithium, valproate, quetiapine); NEVER start antidepressant alone in bipolar (risk of manic switch); safety assessment; driving notification requirements; risk of suicide and impulsive behaviour; family psychoeducation; MDQ and lifetime history review

Interpretation bands for the DSM-5 Bipolar. Apply clinical judgement and local guidance.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). 2013.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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