Icd 10 bipolar disorder

Icd 10 bipolar disorder DEFAULT

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F - Bipolar disorder, unspecified
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F - Bipolar disorder, unspecified
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"F - Bipolar Disorder, Unspecified." ICDCM, 10th ed., Centers for Medicare and Medicaid Services and the National Center for Health Statistics, ICD, www.unboundmedicine.com/icd/view/ICDCM//all/F31_9___Bipolar_disorder__unspecified.
F - Bipolar disorder, unspecified. ICDCM. Centers for Medicare and Medicaid Services and the National Center for Health Statistics; https://www.unboundmedicine.com/icd/view/ICDCM//all/F31_9___Bipolar_disorder__unspecified. Accessed October 28,
F - Bipolar disorder, unspecified. (). In ICDCM (10th edition). Centers for Medicare and Medicaid Services and the National Center for Health Statistics. https://www.unboundmedicine.com/icd/view/ICDCM//all/F31_9___Bipolar_disorder__unspecified
F - Bipolar Disorder, Unspecified [Internet]. In: ICDCM. Centers for Medicare and Medicaid Services and the National Center for Health Statistics; [cited October 28]. Available from: https://www.unboundmedicine.com/icd/view/ICDCM//all/F31_9___Bipolar_disorder__unspecified.
TY - ELEC T1 - F - Bipolar disorder, unspecified ID - BT - ICDCM UR - https://www.unboundmedicine.com/icd/view/ICDCM//all/F31_9___Bipolar_disorder__unspecified PB - Centers for Medicare and Medicaid Services and the National Center for Health Statistics ET - 10 DB - ICD DP - Unbound Medicine ER -
Sours: https://www.unboundmedicine.com/icd/

ICDCM Diagnosis Code F

  1. ICDCM Codes
  2. FF99 Mental, Behavioral and Neurodevelopmental disorders
  3. FF39 Mood [affective] disorders
  4. F Bipolar disorder
  5. ICDCM Diagnosis Code F

Bipolar disorder, unspecified

    Billable/Specific Code
  • F is a billable/specific ICDCM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The edition of ICDCM F became effective on October 1,
  • This is the American ICDCM version of F - other international versions of ICD F may differ.
The following code(s) above F contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to F
  • FF99
    ICDCM Range FF99

    Mental, Behavioral and Neurodevelopmental disorders
    Includes
    • disorders of psychological development
    Type 2 Excludes
    • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (RR99)

    Mental, Behavioral and Neurodevelopmental disorders
  • F31
    ICDCM Diagnosis Code F31

    Bipolar disorder

      Non-Billable/Non-Specific Code
    Includes
    • bipolar I disorder
    • bipolar type I disorder
    • manic-depressive illness
    • manic-depressive psychosis
    • manic-depressive reaction
    Type 1 Excludes
    • bipolar disorder, single manic episode (F)
    • major depressive disorder, single episode (F)
    • major depressive disorder, recurrent (F)
    Bipolar disorder
Approximate Synonyms
  • Bipolar 1 disorder
  • Bipolar 1 disorder, depressed episode
  • Bipolar 1 disorder, depressed episode w catatonia
  • Bipolar 1 disorder, depressed episode w mixed features
  • Bipolar 1 disorder, depressed episode w rapid cycling
  • Bipolar 1 disorder, manic episode
  • Bipolar 1 disorder, manic episode w catatonia
  • Bipolar 1 disorder, manic episode w mixed features
  • Bipolar disorder
  • Bipolar disorder in partial remission
  • Bipolar disorder, mild
  • Bipolar disorder, moderate
  • Bipolar disorder, partial remission
  • Bipolar disorder, severe, with psychosis
  • Bipolar disorder, severe, without psychosis
  • Bipolar i disorder
  • Bipolar i disorder, most recent episode depressed with catatonic features
  • Bipolar i disorder, most recent episode manic with catatonic features
  • Depressed bipolar i disorder
  • Manic bipolar i disorder
  • Mild bipolar disorder
  • Mixed depressed bipolar i disorder
  • Mixed manic bipolar i disorder
  • Moderate bipolar disorder
  • Rapid cycling depressed bipolar i disorder
  • Severe bipolar disorder with psychotic features
  • Severe bipolar disorder with psychotic features, mood-congruent
  • Severe bipolar disorder with psychotic features, mood-incongruent
  • Severe bipolar disorder without psychotic features
Clinical Information
  • A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.
  • A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. (mesh)
  • Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go from very happy, "up," and active to very sad and hopeless, "down," and inactive, and then back again. They often have normal moods in between. The up feeling is called mania. The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. Abnormal brain structure and function may also play a role. Bipolar disorder often starts in a person's late teen or early adult years. But children and adults can have bipolar disorder too. The illness usually lasts a lifetime.if you think you may have it, tell your health care provider. A medical checkup can rule out other illnesses that might cause your mood changes.if not treated, bipolar disorder can lead to damaged relationships, poor job or school performance, and even suicide. However, there are effective treatments to control symptoms: medicine and talk therapy. A combination usually works best.
ICDCM F is grouped within Diagnostic Related Group(s) (MS-DRG v):

Convert F to ICDCM

Code History
  • (effective 10/1/): New code (first year of non-draft ICDCM)
  • (effective 10/1/): No change
  • (effective 10/1/): No change
  • (effective 10/1/): No change
  • (effective 10/1/): No change
  • (effective 10/1/): No change
  • (effective 10/1/): No change
ICDCM Codes Adjacent To F
F Bipolar disorder, in full remission, most recent episode hypomanic
F Bipolar disorder, in partial remission, most recent episode manic
F Bipolar disorder, in full remission, most recent episode manic
F Bipolar disorder, in partial remission, most recent episode depressed
F Bipolar disorder, in full remission, most recent episode depressed
F Bipolar disorder, in partial remission, most recent episode mixed
F Bipolar disorder, in full remission, most recent episode mixed
F Other bipolar disorders
F Bipolar disorder, unspecified
F Major depressive disorder, single episode, mild
F Major depressive disorder, single episode, moderate
F Major depressive disorder, single episode, severe without psychotic features
F Major depressive disorder, single episode, severe with psychotic features
F Major depressive disorder, single episode, in partial remission
F Major depressive disorder, single episode, in full remission
F Other depressive episodes
F Premenstrual dysphoric disorder
F Other specified depressive episodes

Reimbursement claims with a date of service on or after October 1, require the use of ICDCM codes.

Sours: https://www.icd10data.com/ICD10CM/Codes/FF99/FF39/F/F
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Bipolar disorder diagnosis: challenges and future directions

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What is bipolar disorder? (English subtitles)

Bipolar disorder F

Type 1 Excludes

Type 1 Excludes Help

A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as F A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

  • bipolar disorder, single manic episode (

    ICDCM Diagnosis Code F30

    • F30 Manic episode
      • F Manic episode without psychotic symptoms
        • F Manic episode without psychotic symptoms, uns
        • F Manic episode without psychotic symptoms, mil
        • F Manic episode without psychotic symptoms, mod
        • F Manic episode, severe, without psychotic symp
      • F Manic episode, severe with psychotic symptoms
      • F Manic episode in partial remission
      • F Manic episode in full remission
      • F Other manic episodes
      • F Manic episode, unspecified
    F)
  • major depressive disorder, single episode (

    ICDCM Diagnosis Code F32

    • F32 Depressive episode
      • F Major depressive disorder, single episode, mi
      • F Major depressive disorder, single episode, mo
      • F Major depressive disorder, single episode, se
      • F Major depressive disorder, single episode, se
      • F Major depressive disorder, single episode, in
      • F Major depressive disorder, single episode, in
      • F Other depressive episodes
        • F Premenstrual dysphoric disorder
        • F Other specified depressive episodes
      • F Major depressive disorder, single episode, un
      • FA Depression, unspecified
    F)
  • major depressive disorder, recurrent (

    ICDCM Diagnosis Code F33

    • F33 Major depressive disorder, recurrent
      • F Major depressive disorder, recurrent, mild
      • F Major depressive disorder, recurrent, moderat
      • F Major depressive disorder, recurrent severe w
      • F Major depressive disorder, recurrent, severe
      • F Major depressive disorder, recurrent, in remi
        • F Major depressive disorder, recurrent, in remi
        • F Major depressive disorder, recurrent, in part
        • F Major depressive disorder, recurrent, in full
      • F Other recurrent depressive disorders
      • F Major depressive disorder, recurrent, unspeci
    F)
Type 2 Excludes

Type 2 Excludes Help

A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (F31) and the excluded code together.

  • cyclothymia (

    ICDCM Diagnosis Code F

    Cyclothymic disorder

      Billable/Specific Code
    Applicable To
    • Affective personality disorder
    • Cycloid personality
    • Cyclothymia
    • Cyclothymic personality
    F)
Includes

Includes Help

"Includes" further defines, or give examples of, the content of the code or category.

  • bipolar I disorder
  • bipolar type I disorder
  • manic-depressive illness
  • manic-depressive psychosis
  • manic-depressive reaction
Clinical Information
  • A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.
  • A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. (mesh)
  • Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go from very happy, "up," and active to very sad and hopeless, "down," and inactive, and then back again. They often have normal moods in between. The up feeling is called mania. The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. Abnormal brain structure and function may also play a role. Bipolar disorder often starts in a person's late teen or early adult years. But children and adults can have bipolar disorder too. The illness usually lasts a lifetime.if you think you may have it, tell your health care provider. A medical checkup can rule out other illnesses that might cause your mood changes.if not treated, bipolar disorder can lead to damaged relationships, poor job or school performance, and even suicide. However, there are effective treatments to control symptoms: medicine and talk therapy. A combination usually works best.

Codes

  • F31 Bipolar disorder
    • F Bipolar disorder, current episode hypomanic
    • F Bipolar disorder, current episode manic without psychotic features
      • F &#;&#; unspecified
      • F &#;&#; mild
      • F &#;&#; moderate
      • F &#;&#; severe
    • F Bipolar disorder, current episode manic severe with psychotic features
    • F Bipolar disorder, current episode depressed, mild or moderate severity
      • F &#;&#; unspecified
      • F Bipolar disorder, current episode depressed, mild
      • F Bipolar disorder, current episode depressed, moderate
    • F Bipolar disorder, current episode depressed, severe, without psychotic features
    • F Bipolar disorder, current episode depressed, severe, with psychotic features
    • F Bipolar disorder, current episode mixed
      • F &#;&#; unspecified
      • F &#;&#; mild
      • F &#;&#; moderate
      • F &#;&#; severe, without psychotic features
      • F &#;&#; severe, with psychotic features
    • F Bipolar disorder, currently in remission
      • F &#;&#; most recent episode unspecified
      • F Bipolar disorder, in partial remission, most recent episode hypomanic
      • F Bipolar disorder, in full remission, most recent episode hypomanic
      • F Bipolar disorder, in partial remission, most recent episode manic
      • F Bipolar disorder, in full remission, most recent episode manic
      • F Bipolar disorder, in partial remission, most recent episode depressed
      • F Bipolar disorder, in full remission, most recent episode depressed
      • F Bipolar disorder, in partial remission, most recent episode mixed
      • F Bipolar disorder, in full remission, most recent episode mixed
    • F Other bipolar disorders
    • F Bipolar disorder, unspecified
Sours: https://www.icd10data.com/ICD10CM/Codes/FF99/FF39/F

Bipolar icd disorder 10

ICD Version

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What is bipolar disorder? (English subtitles)

Bipolar disorders in ICD current status and strengths

  • Short Communication
  • Open Access
  • Published:

International Journal of Bipolar Disordersvolume 8, Article number: 3 () Cite this article

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Abstract

Background

The Clinical descriptions and diagnostic guidelines for the ICD Classification of mental and behavioural disorders should soon be finalized. To measure their potential impact, the new proposed definitions of bipolar disorders in ICD were applied to data from the Zurich cohort study and compared with the definitions of ICD and DSM

Results

We found little difference between ICD and ICD in the identification of subjects with bipolar disorders, but compared to DSM-5 a considerable increase in the diagnosis of hypomanic episodes and therefore of bipolar-II disorders.

Conclusions

Compared to ICD and DSM-5 the definition of hypomanic episodes according to ICD represents important progress. A higher prevalence of BP-II disorder makes sense from a clinical point of view. Further transcultural research is needed into whether out-patient treatment should be included as a criterion for hypomania. Pure mania is unfortunately missing as an independent and codable disorder in the international diagnostic manuals, whether ICD or DSM

Introduction

The World Health Organization is central to the continuous development of the diagnostic classification of medical disorders. With the ICD officially approved, the next stage in our field will be the publication of the Clinical Descriptions and Diagnostic Guidelines (CDDG) for the manual’s Mental and Behavioural Disorders section. The guidelines are currently out for consultation and comment. From the ICD should be in worldwide use. The ICD review process has taken over ten years, partly overlapping with the fifth revision of the DSM of the American Psychiatric Association, which was completed in From the outset the general aim was to harmonise their structure and descriptions in order to avoid arbitrary differences (Reed et al. ).

Differences persist nonetheless. In its conception the ICD is guided by the principles of clinical usefulness and global applicability. In particular, its descriptions of the “essential features” of mood episodes are not presented as equivalents of strict diagnostic criteria. Symptom counts or duration cut-offs are generally avoided, which is designed to reflect clinical practice and the exercise of clinical judgment. A full account of the changes in ICD and their rationale is to be found in (Reed et al. ).

The purpose of this short paper is to compare the definitions of manic and hypomanic episodes in ICD (as it currently stands) (a) briefly with the previous version ICD (World Health Organization ) and (b) with DSM-5 of the American Psychiatric Association (American Psychiatric Association ). By applying the criteria to data from the Zurich study, described in detail in an earlier publication (Angst et al. ), we can provisionally illustrate some consequences of the revisions.

Zurich study sample and definitions

The Zurich study is an epidemiological study, which followed the probands over a period of 30 years from the ages of 19/20 to 49/ The interview sample was selected from an initial cohort of people (f = ; m = ) representative of the canton of Zurich in Switzerland, who were screened in by the Symptom Checklist 90 (SCLR) (Derogatis ) when they were 19 years old (males) or 20 years old (females).

To increase the probability of the development of psychiatric syndromes, a stratified sub-sample of subjects was selected for the longitudinal study. Two-thirds of the sample consisted of high scorers (defined as scoring above the 85th percentile of the global severity index of the SCLR) (n = ) and one-third of a random sample of those with scores below the 85th percentile (n = ). The use of stratified samples is not uncommon in epidemiological research (Dunn et al. ). Altogether, seven interview waves were conducted: in , , , , , and For the present analysis only data collected from onwards were used; in an interview section on mania was added to the interview. The initial allocation to the two strata did not change over the study’s time span.

The analysis is presented both with the raw figures (n =  in the period –) and with figures after reweighting to offset the stratification (n = ). For the reweighting, the analysis was conducted with the SAS procedure PROC SURVEYFREQ.

For the definitions of ICD we have used the documents available on the internet. For the ICD, diagnostic criteria for research were subsequently published, distinct from of the CDDG for clinicians, (ICD DCR) (World Health Organization ). These imposed both symptom numbers and duration cut-offs, narrowing the differences between the ICD and DSM-IV. We applied ICD DCR definitions in our analyses of ICD but this approach was not extended to ICD, as there is no indication that diagnostic research criteria will be produced for this latest revision.

Bipolar disorders in ICD

The mood disorders section in ICD has been reorganized, opening with the description of mood episodes (depressive, manic, mixed and hypomanic), which are not coded. Codes are ascribed to disorders, which are diagnosed on the basis of the pattern of a patient’s mood episodes over time. Moreover, in the bipolar and related disorders grouping newer research led to the subdivision of bipolar disorder into types I and II, based on the distinction between mania and hypomania (Reed et al. ). This is in line with DSM

Mania as a diagnosis

Historically bipolar disorders (BP) included mania, BP-I, BP-II, hypomania and cyclothymic disorders. The international diagnostic manuals do not reflect the full affective spectrum. In none of them does mania have the status of a separate disorder. Since ICD a manic episode has been codable only within mood disorders. Those with mania/a manic episode are diagnosed as having bipolar-I disorder. ICD continues this tradition, which is in line with the successive versions of the DSM, including DSM This must nonetheless be considered a loss in both clinical and research terms. There is growing evidence from epidemiological, clinical and genetic studies that unipolar mania exists as a distinct disorder (Merikangas et al. ; Baek et al. ; Angst and Grobler ). A recent analysis of data merged from seven epidemiological studies of adults found BP-I (mania with major depressive disorder) in subjects and pure mania in , a relatively rare but separate diagnosis (Angst et al. ).

Major change in the definitions of manic and hypomanic syndromes and episodes in ICD and DSM-5

The definitions of manic and hypomanic syndromes and episodes in the two manuals are now almost identical as regards entry criteria, duration, hospitalization, and the presence or absence of psychotic features and impairment in social and occupational functioning, albeit with the dissimilarities referred to above (essential features vs. lettered entry criteria, etc.).

All manic and hypomanic episodes in ICD require as defining features:

  1. 1.

    euphoria, irritability or expansiveness, and, increased activity or subjective experience of increased energy

  2. 2.

    plus “several “(ICD), three or more (DSM 5) of the following 7 symptoms:

    1. 1.

      increased talkativeness or pressured speech,

    2. 2.

      flight of ideas,

    3. 3.

      increased self-esteem or grandiosity,

    4. 4.

      decreased need of sleep,

    5. 5.

      distractibility,

    6. 6.

      impulsive reckless behaviour,

    7. 7.

      increase in sexual drive, sociability or goal-directed activity.

Thus, a diagnosis of bipolar mood disorders in both ICD and DSM-5 now requires as an essential entry feature not only the presence of elated/euphoric, expansive or irritable mood but in addition, in all cases, increased activity/energy; this is in contrast to both ICD and DSM-IV TR (American Psychiatric Association ) which required as criterion A only the presence of mood changes. This development is not without problems. Earlier, we illustrated the consequences of this important conceptual change, as introduced by DSM-5, with data from the Bridge Study. of (%) patients with Major Depression manifested only one mood criterion for bipolarity (elated or irritable). Following DSM-IV criteria those patients were diagnosed with bipolar disorders, whereas according to DSM-5 they lost their bipolarity and were re-diagnosed as having major depressive disorder (Angst et al. ).

Manic and hypomanic episodes in ICD compared to DSM-5

DSM-5 defines manic episodes and hypomanic episodes slightly more restrictively (as had the ICD DCR) in that for cases with mood irritability only (without euphoria) it requires 4 rather than 3 of the 7 symptoms for a diagnosis; ICD does not single out irritability in this way.

Similarly the minimum duration of a hypomanic episode is 4+ days in DSM-5 and “several days” in ICD For the purposes of our analysis several was interpreted as 4+ consecutive days.

One further restriction in the definition of a hypomanic episode in DSM-5 relates to changes in functioning. In DSM-5 criterion C: an unequivocal change in functioning uncharacteristic of the person, and criterion D: the disturbance in mood and the change in functioning are observable by others must be met. In ICD this is less categorically expressed as the significant change in the usual range of moods and behaviour would be apparent to people who know the individual well.

Exclusions

Like DSM-5, ICD excludes syndromes caused by the effects of a substance or medication, another medical condition (tumour etc.), but now allows the diagnosis of a manic or hypomanic episode if the full syndrome persists after antidepressant treatment (e.g. medication, ECT, light therapy) is discontinued and its direct effects have ceased or receded.

Causal attributions and exclusions are, however, known to be problematic and not data based.

Comparison of diagnostic systems using data from the Zurich study: ICD, ICD and DSM-5

ICD and ICD manic symptoms, hypomania and mania

Comparing ICD with ICD (ICD DCR) our analysis (Table 1) found a minimal reduction in the frequency of ICD manic episodes (N = 29) compared to ICD (31). On the other hand ICD diagnosed 48 subjects with a hypomanic episode vs. 40 by ICD

Full size table

Prevalence rates have to be weighted, because in the Zurich study risk cases (high scorers on the SCL R) were purposely over-represented (Table 2).

Full size table

ICD and DSM manic symptoms, hypomania and mania

ICD and DSM-5 are in close agreement in the diagnosis of manic episodes (Table 3) but hypomanic episodes are far more frequently identified by ICD (N = 48) than DSM-5 (N = 15); only 10 subjects are classified by both.

Full size table

Application of ICD results in prevalence of mania in %, DSM-5 in %. But hypomania is diagnosed by ICD far more frequently in % compared to DSM-5 in %. The prevalence rates are shown in Table 4.

Full size table

Validity of the ICD diagnoses

As validators we can provide family history (parents, siblings) and lifetime treatment for manic or depressive symptoms.

As is clear in Table 5, a positive family history (FH+) is strongly correlated with the diagnostic groups of mania and hypomania. Both diagnostic subgroups correlate significantly in their FH + for mania, suicide/attempts, alcohol abuse/dependence and anxiety/panic. But there is no association with a FH + for depression or smoking.

Full size table

Table 6 lists percentage treatment rates for manic and depressive symptoms for ICD, ICD and DSM The three diagnostic classifications show very similar validity regarding the treatment of manic symptoms but none for the treatment of depressive symptoms.

Full size table

If ICD currently classifies patients who have been hospitalized for manic syndromes as having manic episodes, individuals with manic symptoms who have been treated could reasonably be diagnosed as hypomanic. In Table 6 we show this to be the case for 4 of subjects (%), who, if added to the subjects with hypomania, would increase their number from 48 to The prevalence rate would correspondingly increase from to %. Of course further research into this approach is needed.

In order to test the hypothesis of a continuum from normal to pathological, one might also look at recurrent brief hypomania among those with manic symptoms (Angst ). It is present in 37 subjects, with a prevalence of %. Cumulatively % of individuals manifested manic, hypomanic or brief hypomanic episodes.

Conclusions

Compared to ICD and DSM-5, the current ICD definition of hypomanic episodes represents important progress. Hypomanic episodes will be diagnosed twice as frequently as manic episodes. From a clinical point of view it makes sense that the milder condition should occur more often than the severe one. This also means that bipolar-II disorder will become a more common diagnosis. It should be remembered that hypomanic episodes in terms of their social and subjective consequences are not always undesirable. They can be associated with an increased work capacity and heightened creativity. Transcultural research is needed into whether out-patient treatment should be included as a criterion for a diagnosis of hypomania, in parallel with the hospitalization criterion for a manic episode. Finally, ICD allows greater scope for the exercise of clinical judgment, which is an important strength of this classification system.

Availability of data and materials

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Acknowledgements

Not applicable.

Funding

This work was supported by Grant Nos /1 and of the Swiss National Science Foundation.

Author information

Affiliations

  1. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland

    Jules Angst, Vladeta Ajdacic-Gross & Wulf Rössler

  2. Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of São Paulo, São Paulo, Brazil

    Wulf Rössler

  3. Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany

    Wulf Rössler

Contributions

JA drafted the manuscript and conducted all the statistical analyses. WR participated in the critical revision of the manuscript. VAG revised the statistical results. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jules Angst.

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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of , as revised in The project received prior approval () from the Ethical Committee of the Zurich University Psychiatric Hospital.

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The authors declare that they have no competing interests.

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Angst, J., Ajdacic-Gross, V. & Rössler, W. Bipolar disorders in ICD current status and strengths. Int J Bipolar Disord8, 3 (). https://doi.org//s

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