Table 3.

Criteria for Bipolar Disorder Not Otherwise Specified in the Course of Bipolar Youth Study

Child does not meet the DSM-IV criteria for BP-I or BP-II A distinct period of abnormally elevated, expansive, or irritable mood plus the following: At least 2 DSM-IV-TR “B” manic symptoms (3 if the mood is irritability only) that are clearly associated with the onset of abnormal mood A clear change in functioning the presence of the elated and/or irritable mood and manic symptoms for a significant part of the day (a minimum of 4 hours, though this did not necessarily need to be expressed consecutively) a minimum of 4 days (not necessarily consecutive) meeting criteria B.1-B.3 over the subject’s lifetime Mood and affective symptoms must be abnormal for the child’s level of development and environment Symptoms or mood changes that occur during substance use or antidepressant treatment do not count toward a bipolar diagnosis. Exclusion criteria: Current or lifetime DSM-IV diagnosis of schizophrenia, mental retardation, autism, or severe autism spectrum disorders Mood disorders due to substance abuse, a medical condition, or secondary to use of medications (e.g. corticosteroids). Subjects determined to have the onset of BP before comorbid substance use disorders are included Subjects with mild comorbid Asperger disorder or pervasive developmental disorder–not otherwise specified (PDD-NOS) are included if their mood symptomatology was clearly episodic and best accounted for by the bipolar diagnosis