A 26-year-old man reports four consecutive days of elevated mood, decreased need for sleep, and increased talkativeness. He was not hospitalized and has no psychosis. His function at work is unimpaired. What is the correct DSM-5 classification of this episode?

• A Manic episode because elevated mood is present
• B Unspecified bipolar and related disorder because four days is below any diagnostic threshold
• C Cyclothymic disorder episode
• D Hypomanic episode, since the duration meets the four-day threshold and there is no marked impairment or psychosis ✓

Explanation

DSM-5 defines a hypomanic episode as a distinct period of elevated or irritable mood plus increased activity lasting at least four consecutive days, clearly different from usual functioning, without psychosis and without marked social or occupational impairment. A manic episode requires seven days or any duration if hospitalization is needed. Four days therefore satisfies hypomania exactly, and unspecified bipolar disorder applies only when full criteria are not met.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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