Bipolar Disorders: A Case Study

Copyright ª Blackwell Munksgaard 2005 Bipolar Disorders 2005: 7(Suppl. 3): 5–69
BIPOLAR DISORDERS

Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies
Yatham LN, Kennedy SH, O’Donovan C, Parikh S, MacQueen G, McIntyre R, Sharma V, Silverstone P, Alda M, Baruch P, Beaulieu S, Daigneault A, Milev R, Young T, Ravindran A, Schaffer A, Connolly M, Gorman CP. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disord 2005: 7 (Suppl. 3): 5–69. ª Blackwell Munksgaard, 2005

Co-Chairs: Lakshmi N Yathama, Sidney H Kennedyb Section Leaders: Claire
Bipolar disorder – diagnostic features (DSM-IV) (18) Mania A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (any duration if hospitalization is necessary) Persistence of three or more of the following symptoms to a significant degree: 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep (e.g. feels rested after only 3 h of sleep) 3. More talkative than usual or pressure to keep talking 4. Flight of ideas or subjective experience that thoughts are racing 5. Distractibility 6. Increase in goal-directed activity or psychomotor agitation 7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g. engaging in unrestrained buying sprees, sexual indiscretions or foolish business investments) Hypomania A distinct period of persistently elevated, expansive or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non-depressed mood Persistence of three or more of the symptoms necessary for a manic episode Cyclothymic disorder The presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode, for at least 2 years During the above 2-year period, the person has not been without the symptoms for more than 2 months at a time No major depressive episode, manic episode, or mixed episode has been present during the first 2 years of the disturbance Bipolar disorder not otherwise specified 1. Very rapid alternation (days) between manic and depressive symptoms that do not meet duration criteria 2. Recurrent hypomania without intercurrent depressive symptoms 3. Manic or mixed episode superimposed on delusional or psychotic disorder 4. Unable to determine if bipolar disorder is primary, substanceinduced or related to a medical