Diagnostic Considerations

The diagnosis of bipolar affective disorder, or manic-depressive illness (MDI), is based on the patient’s history and clinical course.

Other conditions to be considered include the following:

• Epilepsy
• Fahr disease
• Acquired immunodeficiency syndrome (AIDS)
• Medications (eg, antidepressants can propel a patient into mania; other medications may include baclofen, bromide, bromocriptine, captopril, cimetidine, corticosteroids, cyclosporine, disulfiram, hydralazine, isoniazid, levodopa, methylphenidate, metrizamide, procarbazine, procyclidine)
• Circadian rhythm desynchronization
• Cyclothymic disorder
• Multiple personality disorder
• Oppositional defiant disorder (in children)
• Substance abuse disorders (eg, with alcohol, amphetamines, cocaine, hallucinogens, opiates)