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Bipolar disorders
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Bipolar disorders

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Contributors: Shea A. Nagle BA, Michael W. Winter MD, Richard L. Barbano MD, PhD
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Synopsis

Bipolar disorder is an affective disorder characterized by severe fluctuations in mood, involving episodes of mania, hypomania, and major depression, with oscillating remission and recurrence. There are 2 subtypes:
  • Bipolar type 1 – Patients experience manic episodes and, in most cases, also experience major depressive and hypomanic episodes.
  • Bipolar type 2 – Patients experience at least 1 hypomanic episode and at least 1 major depressive episode but do not have manic episodes.
Mania is a major criterion for bipolar type 1. Hypomania, a major criterion for bipolar type 2, consists of some of the same characteristics but generally does not result in the same functional impairment. Mania is often characterized by an expansive euphoria, inflated self-esteem, grandiosity, disinhibition, and increased irritability. Many patients engage in riskier behaviors during manic episodes, including substance use, spending excessive money, etc. Other signs of mania include pressured speech, racing thoughts, flight of ideas, distractibility, psychomotor agitation, restlessness, hypersexuality, and insomnia or sleep disturbance. Mania may also present with psychotic symptoms.

The estimated prevalence of bipolar type 1 and bipolar type 2 disorders in the United States is 1.8%. The bipolar disorders have the highest genetic link of all major mental illnesses, with an up to tenfold increase in risk among individuals with relatives who have bipolar disorders. Symptoms usually begin in early adulthood, and bipolar disorder is less commonly diagnosed during childhood or adolescence. There is no difference between the sexes in prevalence of the disease. However, women are more likely to experience more depressive symptoms than men. There is an increased risk of substance use disorders and suicidal ideation or suicide attempt in individuals with bipolar disorder.

Codes

ICD10CM:
F31.9 – Bipolar disorder, unspecified

SNOMEDCT:
13746004 – Bipolar Disorder

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Last Reviewed: 11/04/2019
Last Updated: 11/15/2019
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Bipolar disorders
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Bipolar disorders (Manic or Hypomanic Episode) : Insomnia, Irritability
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