A 22-year-old patient presents with a 4-day episode of elevated mood, decreased need for sleep, pressured speech, and increased goal-directed activity. This episode does not require hospitalisation and is not precipitated by substances. According to DSM-5, this duration and severity most likely characterises:

• A Manic episode, consistent with Bipolar I Disorder
• B Cyclothymic Disorder
• C Major depressive episode with mixed features
• D Hypomanic episode, consistent with Bipolar II Disorder ✓

Explanation

DSM-5 requires a manic episode to last at least 7 days (or any duration if hospitalisation is required); a hypomanic episode requires at least 4 consecutive days. This 4-day episode without hospitalisation fulfils the minimum for hypomania but not mania, making Bipolar II Disorder the appropriate diagnosis (provided a past or current major depressive episode exists). Cyclothymia involves hypomanic and depressive symptoms not meeting full episode criteria over 2 years.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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