Bipolar disorder not otherwise specified

Last updated
Bipolar disorder NOS
Other namesBipolar disorder, unspecified
Specialty Psychiatry
TreatmentMedication, psychotherapy
Medication Lithium, antipsychotics, anticonvulsants
Frequency1.4%

Bipolar disorder not otherwise specified (BD-NOS) is a diagnosis for bipolar disorder (BD) when it does not fall within the other established sub-types. Bipolar disorder NOS is sometimes referred to as subthreshold bipolar disorder. [1]

Contents

Classification

BD-NOS is a mood disorder and one of four subtypes on the bipolar spectrum, which also includes bipolar I disorder, bipolar II disorder, and cyclothymia. [1] BD-NOS was a classification in the DSM-IV and has since been changed to Bipolar "Other Specified" and "Unspecified" in the 2013 released DSM-5 (American Psychiatric Association, 2013). BD-NOS is a disorder which creates intense mood instability which causes bouts of depression, hypomania, and mania, and occasionally mood stability.

Diagnosis

Bipolar disorder is difficult to diagnose. [2] If a person displays some symptoms of bipolar disorder but not others, the clinician may diagnose bipolar NOS. The diagnosis of bipolar NOS is indicated when there is a rapid change (days) between manic and depressive symptoms and can also include recurring episodes of hypomania. Bipolar NOS may be diagnosed when it is difficult to tell whether bipolar is the primary disorder due to another general medical condition, such as a substance use disorder. A diagnosis of this condition can be challenging and is often imprecise. [3] [4]

People with bipolar NOS and bipolar I disorder have similar symptom and family history profiles. [5] Children and youth with bipolar NOS are at high risk to develop bipolar I disorder or bipolar II disorder as they age. [5] [6] [7]

Treatment

Individual approaches to treatment are recommended, usually involving a combination of mood stabilizers and atypical antipsychotics. [8] Psychotherapy may be beneficial and should be started early. [8]

Epidemiology

The prevalence of BD-NOS is 1.4%. [1] The prevalence of the larger category of bipolar spectrum disorder has been estimated to be as high as 6% of the population. [9] [10] [11]

See also

References

  1. 1 2 3 "International impact of bipolar disorder highlights need for recognition and better treatment availability". March 7, 2011. Archived from the original on April 26, 2012. Retrieved April 25, 2012.
  2. ↑ Leboyer M, Kupfer DJ (December 2010). "Bipolar disorder: new perspectives in health care and prevention". J Clin Psychiatry. 71 (12): 1689–95. doi:10.4088/JCP.10m06347yel. PMC   3317891 . PMID   21190640.
  3. ↑ "Unspecified bipolar disorder: Definition, Symptoms, and Treatment". www.medicalnewstoday.com. 2023-05-19. Retrieved 2023-10-26.
  4. ↑ Towbin, Kenneth; Axelson, David; Leibenluft, Ellen; Birmaher, Boris (May 2013). "Differentiating Bipolar Disorder–Not Otherwise Specified and Severe Mood Dysregulation". Journal of the American Academy of Child and Adolescent Psychiatry. 52 (5): 466–481. doi:10.1016/j.jaac.2013.02.006. ISSN   0890-8567. PMC   3697010 . PMID   23622848.
  5. 1 2 Towbin, Kenneth; Axelson, David; Leibenluft, Ellen; Birmaher, Boris (May 2013). "Differentiating bipolar disorder-not otherwise specified and severe mood dysregulation". Journal of the American Academy of Child and Adolescent Psychiatry. 52 (5): 466–481. doi:10.1016/j.jaac.2013.02.006. ISSN   1527-5418. PMC   3697010 . PMID   23622848.
  6. ↑ Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D. (2011-10-01). "Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression From Bipolar Disorder Not Otherwise Specified". Journal of the American Academy of Child & Adolescent Psychiatry. 50 (10): 1001–1016.e3. doi:10.1016/j.jaac.2011.07.005. ISSN   0890-8567.
  7. ↑ Martinez, Molly S.; Fristad, Mary A. (2013-06-01). "Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion". Journal of Affective Disorders. 148 (2): 431–434. doi:10.1016/j.jad.2012.06.018. ISSN   0165-0327.
  8. 1 2 Filaković P, Erić AP, Požgain I (September 2011). "New strategies in the treatment of bipolar disorder" (PDF). Psychiatr Danube. 23 (3): 293–9. PMID   21963700.
  9. ↑ Merikangas, Kathleen R.; Akiskal, Hagop S.; Angst, Jules; Greenberg, Paul E.; Robert M. A. Hirschfeld; Petukhova, Maria; Kessler, Ronald C. (2007-05-01). "Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication". Archives of General Psychiatry. 64 (5). doi:10.1001/archp. ISSN   0003-990X. Archived from the original on 2025-11-12.
  10. ↑ Angst, Jules; Gamma, Alex; Benazzi, Franco; Ajdacic, Vladeta; Eich, Dominique; Rössler, Wulf (Jan 2003). "Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania". Journal of Affective Disorders. 73 (1–2): 133–146. doi:10.1016/s0165-0327(02)00322-1. ISSN   0165-0327. PMID   12507746.
  11. ↑ Judd, Lewis L.; Akiskal, Hagop S. (Jan 2003). "The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases". Journal of Affective Disorders. 73 (1–2): 123–131. doi:10.1016/s0165-0327(02)00332-4. ISSN   0165-0327. PMID   12507745.
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