Document ID: chunk:federal_register_of_legislation:F2018L00869:clause:1_1:p6
Version: federal_register_of_legislation:F2018L00869
Segment Type: clause
Provision Reference: sch 1 cl 1 (pt 6/9)
Character Range: 27108–30777

episode meets the following diagnostic criteria (derived from DSM‑5):
         1. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least one week and present most of the day, nearly every day (or any duration if hospitalisation is necessary).
          2. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behaviour:
            (i)            inflated self-esteem or grandiosity;
            (ii)         decreased need for sleep (for example, feels rested after only three hours of sleep);
            (iii)       more talkative than usual or pressure to keep talking;
            (iv)        flight of ideas or subjective experience that thoughts are racing;
            (v)          distractibility (that is, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed;
            (vi)        increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (that is, purposeless non-goal-directed activity); or
            (vii)     excessive involvement in activities that have a high potential for painful consequences (for example, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
         C.            The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalisation to prevent harm to self or others, or there are psychotic features.
         D.           The episode is not attributable to the physiological effects of a substance (for example, a drug of abuse, a medication, other treatment) or another medical condition.
         Note 1: A full manic episode that emerges during antidepressant treatment (for example, medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and, therefore, a bipolar I diagnosis.
         Note 2: Criteria A–D constitute a manic episode.  At least one lifetime manic episode is required for the diagnosis of bipolar I disorder.
         Note 3: bipolar I disorder and DSM-5 are also defined in the Schedule 1 - Dictionary.
                               medical condition as specified means an endocrine, cardiovascular, respiratory, metabolic, infectious or neurological condition, that causes symptoms consistent with bipolar disorder, as a direct physiological consequence of the condition.
         Note:   Examples of these medical conditions include:
         (a)             adrenal insufficiency;
         (b)            Alzheimer-type dementia;
         (c)             cerebral trauma;
         (d)            cerebrovascular accident;
         (e)             Cushing syndrome;
         (f)             epilepsy;
         (g)            Graves' disease;
         (h)            human immunodeficiency virus;
         (i)              hypothyroidism;
         (j)              multiple sclerosis;
         (k)            Parkinson's disease; or
         (l)              toxoplasmosis.
                               medical condition is a direct physiological cause of the mood symptoms means signs or symptoms of depressed, elevated, expansive or irritable mood are directly related to the pathological process of the medical condition, and:
         (a)          the bipolar disorder has a