Upon admission to a hospital for a severe manic episode, a patient exhibits an excitable, cheerful demeanor as well as psychotic delusions of being a celebrity. These symptoms all disappear after six weeks of treatment. He experiences a normal mood for seven more months before suffering a severe depressive episode. This patient would most likely be diagnosed with which form of bipolar disorder?

A. Bipolar I

B. Bipolar II

C. Rapid-cycling bipolar disorder

D. Cyclothymia

Explanation

A. Bipolar I; Correct. Bipolar I is characterized by both severe manic and depressive episodes that tend to last several weeks. Mood swings can also be accompanied by hallucinations and delusions.

B. Bipolar II; Incorrect. Bipolar II is similar to bipolar I, but the “up” moods do not typically reach full-on mania. Therefore, this patient with a severe manic episode does not have bipolar II disorder.

C. Rapid-cycling bipolar disorder; Incorrect. Rapid-cycling bipolar disorder includes mood swings that occur several times a year, often in rapid succession and is typically  defined by having 4 or more manic or depressive episodes in a year. As the patient went seven months without an episode, it is  unlikely he has rapid-cycling bipolar disorder.

D. Cyclothymia; Incorrect. Cyclothymia is a type of bipolar disorder where mood swings are milder and do not reach full-blown manic or depressive episodes. Since the above patient has both mania and depressive episodes, he does not have cyclothymia.

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