12. Criteria for Mixed Episode*
A. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a l-week period.
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B. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
C. The symptoms are not due to the direct physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment) or a general medical condition (eg, hyperthyroidism).
Note: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (eg, medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar i Disorder.
13. Simplified DSM IV Primary Mood Disorders
1. Unipolar
1. Major Depressive Disorder
1. Never manic or hypomanic
2. Single episode or recurrent MDE
2. Dysthymia
1. Period of chronic dysphoria or disinterest
1. Child or adolescent 1 year
2. Adult 2 years
2. During which
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1. more than half the days dysphoria or disinterest is present and at least 2 associated symptoms of depression
2. Never meets criteria for Depression
3. Any euthymic period is less than 8 weeks
4. Never manic or hypomanic
3. NOS
2. Bipolar
1. Bipolar type I
1. one or more manic episodes
2. Bipolar type II
1. Hypomania but never mania
2. Must have at least one MDE
3. Cyclothymia
1. Period with frequent hypomanic symptoms 1. Child or adolescent I year 2. Adult 2 years
2. During which
1. more than half the days too low or too high
- 2. Never meets criteria for Depression
- 3. Never criteria for mania
- 4. Any euthymic period is less than 8 weeks
4. NOS
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