Bipolar II Disorder

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

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Basics

Description

Bipolar II (BP-II) is a mood disorder characterized by at least one episode of major depression (with or without psychosis) and at least one episode of hypomania, a nonsevere mood elevation.

Geriatric Considerations
New onset in older patients (>50 years) requires a workup for organic or chemically induced pathology.

Pediatric Considerations
Diagnosis less well defined

Pregnancy Considerations
  • Pregnancy does not reduce risk of mood episodes.
  • Need to weigh risk of exposure to mood episode to that of medication
  • Avoid divalproex due to high teratogenicity risk.
  • Postpartum caries high risk of severe acute episode with psychosis and/or infanticidal ideation.

Epidemiology

Onset usually between 15 and 30 years of age

Prevalence
  • 0.5–1.1% lifetime prevalence
  • More common in women

Etiology and Pathophysiology

Dysregulation of biogenic amines or neurotransmitters (particularly serotonin, norepinephrine, and dopamine)

Genetics
Heritability estimate: >77%

Risk Factors

Genetics, major life stressors, or substance abuse

General Prevention

No known way to prevent onset, but treatment adherence and education can help to prevent further episodes.

Commonly Associated Conditions

Substance abuse or dependence, ADHD, anxiety disorders, and eating disorders

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