Bipolar disorder not otherwise specified

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Bipolar disorder NOS

Bipolar disorder not otherwise specified (BD-NOS) is a diagnosis for bipolar disorder (BD) when it does not fall within the other established sub-types. Bipolar disorder NOS is sometimes referred to as subthreshold bipolar disorder.[1]


BD-NOS is a mood disorder and one of four subtypes on the bipolar spectrum, which also includes bipolar I disorder, bipolar II disorder, and cyclothymia.[1] BD-NOS was a classification in the DSM-IV and has since been changed to Bipolar "Other Specified" and "Unspecified" in the 2013 released DSM-5 (American Psychiatric Association, 2013).


Bipolar disorder is difficult to diagnose.[2] If a person displays some symptoms of bipolar disorder but not others, the clinician may diagnose bipolar NOS. The diagnosis of bipolar NOS is indicated when there is a rapid change (days) between manic and depressive symptoms and can also include recurring episodes of hypomania. Bipolar NOS may be diagnosed when it is difficult to tell whether bipolar is the primary disorder due to another general medical condition, such as a substance use disorder.[3]


Individual approaches to treatment are recommended, usually involving a combination of mood stabilizers and atypical antipsychotics.[4] Psychotherapy may be beneficial and should be started early.[4]


The prevalence of BD-NOS is 1.4%.[1]


  1. ^ a b c "International impact of bipolar disorder highlights need for recognition and better treatment availability". March 7, 2011. Archived from the original on April 26, 2012. Retrieved April 25, 2012.
  2. ^ Leboyer M, Kupfer DJ (December 2010). "Bipolar disorder: new perspectives in health care and prevention". J Clin Psychiatry. 71 (12): 1689–95. doi:10.4088/JCP.10m06347yel. PMC 3317891. PMID 21190640.
  3. ^ Diagnostic and Statistical Manual of Mental Disorders (4th ed.). American Psychiatric Association. 1994. p. 366.
  4. ^ a b Filaković P, Erić AP, Požgain I (September 2011). "New strategies in the treatment of bipolar disorder" (PDF). Psychiatr Danube. 23 (3): 293–9. PMID 21963700.

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