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Bipolar Disorder

Bipolar Disorder is a topic covered in the 5-Minute Emergency Consult.

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  • Mania:
    • Presentation is diverse and may be difficult to recognize as mania:
      • Simple irritability
      • Cheerfulness
      • Psychosis
      • Delirium
      • Agitation
    • Full extent of pathology often revealed only by outside informants
    • Onset gradual or acute, duration several weeks or months; rarely may be chronic
  • Hypomania:
    • Milder symptoms without marked impairment
  • Mixed mood:
    • Simultaneous symptoms of mania and depression
    • Treat in ED as for mania
  • Bipolar disorder:
    • Formerly manic depressive disorder
    • Defined as one or more episodes of hypomanic, manic, or mixed mood
    • Possibly with episodes of depressed mood
    • Bipolar II is used to denote cases where hypomania has occurred in the course of the disorder but never mania.
    • Typically begins in the teens or 20s
    • Episodes of abnormal mood may be mild or severe, brief or prolonged, infrequent or chronic, chiefly elevated or chiefly depressed in character.
    • Bipolar disorder may be readily responsive to treatment or nearly intractable.
  • Schizoaffective disorder:
    • Characterized by episodes of altered mood, but psychotic features present even when mood is normal


  • Typically, a primary psychiatric disorder, with genetic association
  • May be secondary to medical disorder (e.g., drug toxicity, endocrine, neurologic process)
  • Particularly likely to be secondary if
    • 1st episode
    • patient >40 yr
    • atypical or mixed presentation
    • abnormal sensorium

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Rosen, Peter, et al., editors. "Bipolar Disorder." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307477/all/Bipolar_Disorder.
Bipolar Disorder. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307477/all/Bipolar_Disorder. Accessed April 25, 2019.
Bipolar Disorder. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307477/all/Bipolar_Disorder
Bipolar Disorder [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307477/all/Bipolar_Disorder.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bipolar Disorder ID - 307477 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307477/all/Bipolar_Disorder PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -