At least 1 manic episode
First episode usually major depressive episode
Factors to consider: family history, onset, medical history, presence of psychotic symptoms, history of lack of response to antidepressant treatment or the emergence of manic episode during antidepressant treatment
Diagnosis is "Bipolar I disorder, with psychotic features" if the psychotic symptoms have occurred EXCLUSIVELY during manic and major depressive episodes
Symptoms of mania in BP1 occur in distinct episodes and typically begin in late adolescence or early adulthood
When assessing a child for mania, the symptoms must represent clear change from the child's typical behavior
Symptoms of mood lability and impulsivity must represent a distinct episode of illness, or there must be a noticeable increase in these symptoms over the individual's baseline in order to justify an additional diagnosis of BP1
