Rationale

Mania/Hypomania is an extremely disabling and potentially harmful behavioral syndrome that indicates an underlying central nervous system disorder. Mania can lead to harm to self or others, and may be accompanied by features of psychosis.

Causal conditions

(list not exhaustive)

1. Bipolar disorder (type I, type II)

2. Substance-induced mood disorder

3. Mood disorder due to a medical condition

4. Cyclothymic disorder

Key Objectives

Given a patient presenting with mania/hypomania, the candidate will diagnose the cause, severity and complications, and will initiate an appropriate management plan. The candidate should pay particular attention to assessment of risk and the potential need for urgent care.

Enabling Objectives

Given a patient with symptoms of mania/hypomania, the candidate will

1. list and interpret critical clinical findings, including

   1. results of an appropriate history, physical examination and assessment of the patient’s mental state;

   2. collateral information, as appropriate (e.g., information from family, friends, previous assessments);

   3. a differential diagnosis based upon differentiation of clinical syndromes presenting with mania/hypomania;

   4. specific risk factors that warrant immediate intervention;

2. list and interpret appropriate investigations, including appropriate laboratory investigations (e.g., toxicology screen, thyroid stimulating hormone);

3. construct an initial management plan including

   1. an assessment of safety (e.g., suicide risk, risk to others);

   2. initiation of appropriate pharmacotherapy if indicated;

   3. appropriate involvement of family and supportive resources;

   4. determination as to whether a referral for specialized care is required (e.g., involuntary admission).