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Bipolar
II Disorder
DSM-IV Diagnostic Criteria
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 disorder.
Clinical Features
- 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.
Epidemiology
- The lifetime prevalence of II is 0.5%
- Possibly more common in women
Classification
Classification 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,
mania 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
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
The treatment of Bipolar II disorder involves lithium and/or
anticonvulsants, and is similar to the treatment
.