## DSM-5 Criteria for Hypomanic Episode **Key Point:** A hypomanic episode requires a **minimum duration of 4 consecutive days** (not 2, 5, or 7) with persistently elevated, expansive, or irritable mood, plus at least 3 additional symptoms from the diagnostic criteria. ### Duration and Symptom Requirements | Feature | Hypomanic Episode | Manic Episode | |---------|-------------------|---------------| | **Duration** | ≥4 consecutive days | ≥7 consecutive days (or any duration if hospitalized) | | **Mood Quality** | Elevated, expansive, or irritable | Elevated, expansive, or irritable | | **Additional Symptoms** | ≥3 from the symptom list | ≥4 from the symptom list | | **Functional Impairment** | No marked impairment required | Marked impairment or hospitalization | | **Psychosis** | Absent by definition | May be present | ### The 3 Symptoms (Need ≥3 for Hypomania) 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep 3. More talkative than usual or pressure of speech 4. Flight of ideas or racing thoughts 5. Distractibility 6. Increase in goal-directed activity (socially, at work, school, or sexually) 7. Excessive involvement in risky activities **High-Yield:** **"Hypo = 4, Manic = 7"** — the 4-day threshold for hypomania vs. 7-day threshold for mania is one of the most frequently tested distinctions in NEET PG psychiatry. **Mnemonic:** **DIG FAST** (Distractibility, Insomnia/decreased need for sleep, Grandiosity, Flight of ideas, Activity increase, Speech increase, Thoughtlessness/risky behavior) — these are the cardinal symptoms to assess in both mania and hypomania; count at least 3 for hypomania, at least 4 for mania.
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