Match each clinical vignette to the most accurate DSM-5 diagnosis.
- A 22-year-old man has a 3-week history of elevated mood, decreased sleep, and grandiosity. He also reports hearing voices plotting against him for the past 2 months, including a 4-week period when his mood was completely normal.Schizoaffective disorder, bipolar type
- A 29-year-old woman with a history of multiple major depressive episodes presents with a 5-day period of increased energy, rapid speech, and racing thoughts. She remains able to attend work and is not hospitalized.Bipolar II disorder
- A 24-year-old man with no prior psychiatric history is brought to the emergency department and hospitalized after 4 days of extreme agitation, euphoria, zero hours of sleep, and reckless financial behavior.Bipolar I disorder
- A 35-year-old woman reports a 3-year history of frequently fluctuating mood, involving distinct periods of mild depressive symptoms alternating with periods of mild elevated mood, without ever meeting full criteria for any mood episode.Cyclothymic disorder
- A 40-year-old man develops acute-onset severe insomnia, pressured speech, and grandiose delusions three days after initiating a high-dose oral prednisone course for a severe asthma exacerbation.Substance/medication-induced bipolar and related disorder
Cevap
The vignettes correctly match to Schizoaffective disorder (due to psychosis in the absence of mood symptoms), Bipolar II disorder (hypomania with past depression), Bipolar I disorder (hospitalization indicating a manic episode), Cyclothymic disorder (chronic, subsyndromal fluctuations), and Substance/medication-induced bipolar disorder (triggered by corticosteroids).
Each diagnosis in the bipolar spectrum has strict DSM-5 requirements. Schizoaffective disorder requires independent psychosis. Bipolar II requires past major depression and current hypomania. Bipolar I requires mania (achieved here via hospitalization). Cyclothymia requires chronic sub-threshold symptoms. Substance-induced requires a clear exogenous trigger like corticosteroids.
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Anahtar Kavram
Diagnostic differentiation of bipolar and related disorders based on episode duration, severity (hospitalization), chronicity, and temporal relationship to psychosis or medications.