skip to main content

Bipolar mania — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardBehaviour ChangeBipolar maniaMCCQE Part 1

A 27-year-old has six days of grandiosity, pressured speech, no need for sleep and dangerous spending. He requires involuntary admission because he is trying to mortgage his parents’ home. Toxicology is negative. Which diagnosis best fits?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Bipolar I disorder, current episode manic with severe impairment

Bipolar I disorder, current episode manic with severe impairment: Severity and hospitalization override the usual one-week duration criterion. Bipolar II disorder, current episode hypomanic with impaired judgment: Hypomania cannot cause the marked functional impairment or need for hospitalization described. Cyclothymic disorder, current episode with subthreshold manic symptoms: Cyclothymia requires chronic fluctuating subthreshold symptoms rather than one severe episode. Generalized anxiety disorder presenting with sustained behavioural activation: Anxiety does not explain sustained expansive mood, grandiosity and decreased need for sleep. Attention-deficit hyperactivity disorder with acute sleep-loss decompensation: ADHD is a persistent developmental pattern and does not present as a discrete severe episodic syndrome.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC5947163/; https://www.canmat.org/sdm_downloads/2018-bipolar-guidelines/