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Bipolar disease state slide kit _ 10 January 2008 [FINAL VERSION] * Features of manic and mixed episodes Manic symptoms can be categorised as affective (related to emotion or mood), cognitive (involving comprehension, judgment, memory, and reasoning), physical (such as changes in appetite or energy levels), and psychotic (especially in more severe mania or depression). The signs and symptoms of mania can last from several days to weeks or months. However, it is also possible for a patient with bipolar disorder to experience symptoms of depression and mania simultaneously in what is referred to as a ‘mixed episode’ or ‘mixed state’. Mixed states are considered to reflect variants of mania rather than depression. Reference American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, American Psychiatric Press; 2000: 382-401. Bipolar disease state slide kit _ 10 January 2008 [FINAL VERSION] * Features of hypomania Symptoms of hypomania are the same as mania, but milder in intensity. Hypomania is defined by the DSM-IV as a distinct period of persistently elevated, expansive, or irritable mood, lasting for at least 4 days*, that is different from usual non-depressed mood. However, by definition, this does not lead to the impairment of daily functioning or hospitalisation. *The duration of hypomania symptoms may be less than 4 days, which is not captured by the DSM. Reference American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, American Psychiatric Press; 2000: 382-401. Bipolar disease state slide kit _ 10 January 2008 [FINAL VERSION] * Subtypes of bipolar disorder Bipolar I disorder Characterised by manic episodes often followed by major depression. Patients with bipolar I disorder must have experienced at least o