Screening for Manic Episodes

Essential Screening Questions

The American Academy of Child and Adolescent Psychiatry recommends asking about distinct periods of abnormally elevated, expansive, or irritable mood lasting at least 7 days, accompanied by persistently increased energy or activity that represented a marked change from their usual self 1, 2
Patients should be asked if they ever had a period where they felt extremely irritable or easily angered for at least a week, where this was very different from their normal self, as recommended by the American Academy of Child and Adolescent Psychiatry 1, 2
The Journal of the American Academy of Child and Adolescent Psychiatry suggests asking if during that time, they needed much less sleep than usual but still felt rested or full of energy 1, 3

The American Academy of Child and Adolescent Psychiatry suggests using a life chart approach, asking the patient to map out when these episodes occurred, how long they lasted, and what treatments they received 1, 3
A strong genetic loading increases the likelihood of true bipolar disorder, as noted by the American Academy of Child and Adolescent Psychiatry, and patients should be asked about family history of bipolar disorder, severe depression, or other mood problems 1, 3
Approximately 20% of youth with major depression develop manic episodes by adulthood, and most bipolar patients experience depressive episodes, according to the American Academy of Child and Adolescent Psychiatry 3, 4

The American Academy of Child and Adolescent Psychiatry warns against confusing chronic irritability or anger outbursts with mania, and recommends verifying that true manic irritability represents a marked change in mental state, not temperamental traits or reactions to conflict 1, 3
The American Academy of Child and Adolescent Psychiatry advises against relying solely on irritability and increased energy without other manic symptoms, as these occur in many conditions 1
Distinguishing reduced need for sleep from insomnia is crucial, as in mania, patients sleep less but feel rested and energized, according to the American Academy of Child and Adolescent Psychiatry 1