{{Infobox medical condition (new) | name = Bipolar disorder NOS | field = Psychiatry | synonyms = Bipolar disorder, unspecified | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = Medication, psychotherapy | medication = Lithium, antipsychotics, anticonvulsants | prognosis = | frequency = 1.4% | deaths = }} '''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.<ref name=InternationalImpact>{{cite web |title= International impact of bipolar disorder highlights need for recognition and better treatment availability |url= https://www.nimh.nih.gov/news/science-updates/2011/international-impact-of-bipolar-disorder-highlights-need-for-recognition-and-better-treatment-availability |date= March 7, 2011 |access-date= April 25, 2012 |archive-url= https://web.archive.org/web/20120426011122/http://www.nimh.nih.gov/science-news/2011/international-impact-of-bipolar-disorder-highlights-need-for-recognition-and-better-treatment-availability.shtml |archive-date= April 26, 2012 |url-status= live }}</ref>
== Classification == 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.<ref name=InternationalImpact/> 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). BD-NOS is a disorder which creates intense mood instability which causes bouts of depression, hypomania, and mania, and occasionally mood stability.
== Diagnosis == Bipolar disorder is difficult to diagnose.<ref name= Leboyer>{{cite journal |vauthors=Leboyer M, Kupfer DJ |title=Bipolar disorder: new perspectives in health care and prevention |journal=J Clin Psychiatry |volume=71 |issue=12 |pages=1689–95 |date=December 2010 |pmid=21190640 |pmc=3317891 |doi=10.4088/JCP.10m06347yel}}</ref> 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. A diagnosis of this condition can be challenging and is often imprecise.<ref>{{Cite web |date=2023-05-19 |title=Unspecified bipolar disorder: Definition, Symptoms, and Treatment |url=https://www.medicalnewstoday.com/articles/unspecified-bipolar-disorder |access-date=2023-10-26 |website=www.medicalnewstoday.com |language=en}}</ref><ref>{{Cite journal |last1=Towbin |first1=Kenneth |last2=Axelson |first2=David |last3=Leibenluft |first3=Ellen |last4=Birmaher |first4=Boris |date=May 2013 |title=Differentiating Bipolar Disorder–Not Otherwise Specified and Severe Mood Dysregulation |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=52 |issue=5 |pages=466–481 |doi=10.1016/j.jaac.2013.02.006 |issn=0890-8567 |pmc=3697010 |pmid=23622848 }}</ref>
People with bipolar NOS and bipolar I disorder have similar symptom and family history profiles.<ref name=":0" /> Children and youth with bipolar NOS are at high risk to develop bipolar I disorder or bipolar II disorder as they age.<ref name=":0">{{Cite journal |last=Towbin |first=Kenneth |last2=Axelson |first2=David |last3=Leibenluft |first3=Ellen |last4=Birmaher |first4=Boris |date=May 2013 |title=Differentiating bipolar disorder-not otherwise specified and severe mood dysregulation |url=https://pmc.ncbi.nlm.nih.gov/articles/PMC3697010/ |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=52 |issue=5 |pages=466–481 |doi=10.1016/j.jaac.2013.02.006 |issn=1527-5418 |pmc=3697010 |pmid=23622848}}</ref><ref>{{Cite journal |last=Axelson |first=David A. |last2=Birmaher |first2=Boris |last3=Strober |first3=Michael A. |last4=Goldstein |first4=Benjamin I. |last5=Ha |first5=Wonho |last6=Gill |first6=Mary Kay |last7=Goldstein |first7=Tina R. |last8=Yen |first8=Shirley |last9=Hower |first9=Heather |last10=Hunt |first10=Jeffrey I. |last11=Liao |first11=Fangzi |last12=Iyengar |first12=Satish |last13=Dickstein |first13=Daniel |last14=Kim |first14=Eunice |last15=Ryan |first15=Neal D. |date=2011-10-01 |title=Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression From Bipolar Disorder Not Otherwise Specified |url=https://www.sciencedirect.com/science/article/pii/S0890856711005806 |journal=Journal of the American Academy of Child & Adolescent Psychiatry |volume=50 |issue=10 |pages=1001–1016.e3 |doi=10.1016/j.jaac.2011.07.005 |issn=0890-8567}}</ref><ref>{{Cite journal |last=Martinez |first=Molly S. |last2=Fristad |first2=Mary A. |date=2013-06-01 |title=Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion |url=https://www.sciencedirect.com/science/article/pii/S0165032712004673 |journal=Journal of Affective Disorders |volume=148 |issue=2 |pages=431–434 |doi=10.1016/j.jad.2012.06.018 |issn=0165-0327}}</ref>
== Treatment == {{Main|Treatment of bipolar disorder}} Individual approaches to treatment are recommended, usually involving a combination of mood stabilizers and atypical antipsychotics.<ref name= Filakovic>{{cite journal |vauthors=Filaković P, Erić AP, Požgain I |title=New strategies in the treatment of bipolar disorder |journal=Psychiatr Danube |volume=23 |issue=3 |pages=293–9 |date=September 2011 |pmid=21963700 |url= http://www.hdbp.org/psychiatria_danubina/pdf/dnb_vol23_no3/dnb_vol23_no3_293.pdf }}</ref> Psychotherapy may be beneficial and should be started early.<ref name=Filakovic/>
==Epidemiology== The prevalence of BD-NOS is 1.4%.<ref name=InternationalImpact/> The prevalence of the larger category of bipolar spectrum disorder has been estimated to be as high as 6% of the population.<ref>{{Cite journal |last=Merikangas |first=Kathleen R. |last2=Akiskal |first2=Hagop S. |last3=Angst |first3=Jules |last4=Greenberg |first4=Paul E. |last5=Robert M. A. Hirschfeld |last6=Petukhova |first6=Maria |last7=Kessler |first7=Ronald C. |date=2007-05-01 |title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication |url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285 |journal=Archives of General Psychiatry |language=en |volume=64 |issue=5 |doi=10.1001/archp |issn=0003-990X |archive-url=https://web.archive.org/web/20251112091226/https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285 |archive-date=2025-11-12 |access-date=2026-01-14 |url-status=live }}</ref><ref>{{Cite journal |last=Angst |first=Jules |last2=Gamma |first2=Alex |last3=Benazzi |first3=Franco |last4=Ajdacic |first4=Vladeta |last5=Eich |first5=Dominique |last6=Rössler |first6=Wulf |date=Jan 2003 |title=Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania |url=https://pubmed.ncbi.nlm.nih.gov/12507746 |journal=Journal of Affective Disorders |volume=73 |issue=1-2 |pages=133–146 |doi=10.1016/s0165-0327(02)00322-1 |issn=0165-0327 |pmid=12507746}}</ref><ref>{{Cite journal |last=Judd |first=Lewis L. |last2=Akiskal |first2=Hagop S. |date=Jan 2003 |title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases |url=https://pubmed.ncbi.nlm.nih.gov/12507745 |journal=Journal of Affective Disorders |volume=73 |issue=1-2 |pages=123–131 |doi=10.1016/s0165-0327(02)00332-4 |issn=0165-0327 |pmid=12507745}}</ref>
== See also == {{Portal|Psychiatry|Psychology|Medicine}}
{{Columns-list|colwidth=22em|
* Bipolar disorder * Bipolar I disorder * Bipolar II disorder * Cyclothymia * International Society for Bipolar Disorders * Outline of bipolar disorder * Bipolar disorders research * Borderline personality disorder * Emotional dysregulation * List of people with bipolar disorder * Mood (psychology) * Mood swing * Ultradian bipolar disorder }}
==References== {{reflist}}
== External links == {{Medical resources | ICD10 = [https://apps.who.int/classifications/apps/icd/icd10online/?gf30.htm+f31 f31.9] | ICD9 = {{ICD9|296.8}} }} {{Mood disorders}}{{Mental disorders}} Category:Bipolar spectrum Category:Mood disorders