Manic Episode Criteria (DSM-IV-TR)

Criteria for a Manic Episode (DSM-IV-TR 2000)

Criteria for a Manic Episode (DSM-TR 2000)[American: 2000]
  • A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
  • B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
    1. Inflated self esteem or grandiosity
    2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
    3. More talkative than usual of pressure to keep talking
    4. Flight of ideas or subjective experience that thoughts are racing
    5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
    6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
    7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, exual indiscretions, or foolish business investments)
  • C. The symptoms do not meet criteria for a Mixed Episode.
  • D. The mood disturbance is sufficiently wevere 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 freatures.
  • E. The symptoms are not due to the direct physiological effect of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hypothyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder)


Compiled and edited by: Catherine Jolma, MD - 6/2010

Page Bibliography

American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision).
4th edition (June 2000) ed. Washington, DC: American Psychiatric Association; 2000. 0890420254