TABLE 4

Research Criteria for the Narrow Phenotype of Juvenile Mania

A. Modification to the DSM-IV-TR criteria for manic episode
 a. The child must exhibit either elevated/expansive mood or grandiosity while also meeting the other DSM-IV-TR criteria for a (hypo)manic episode
B. Guidelines for applying the DSM-IV-TR criteria
 a. Episodes must meet the full duration criteria (ie, at least 7 d for mania and at least 4 d for hypomania) and be demarcated by switches from other mood states (depression, mixed state, euthymic).
 b. Episodes are characterized by a change from baseline in the patient’s mood and, simultaneously, by the presence of the associated symptoms.
 c. Decreased need for sleep should be distinguished from insomnia.
 d. Poor judgment is not a diagnostic criterion unless it is in the context of “increased goal-directed activity” or “excessive involvement in pleasurable activities that have a high potential for painful consequences.”