Low-Dose Quetiapine Induced or Worsened Mania in the Context of Possible Undertreatment

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Table 1. Diagnostic and Statistical Manual of Mental Disorders Criteria for Diagnosis of a Hypomanic and Manic Episode

Hypomanic Episode	Manic Episode
At least 4 consecutive days and present most of the day	At least 1 week and present most of the day or any duration if hospitalization is necessary, or there are psychotic features
During the period of mood disturbance, ≥3 of the following symptoms (4 if the mood is only irritable) are present^*: Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual or pressure to keep taking Flight of ideas or subjective experience that thoughts are racing Distractibility Increase in goal directed activity Excessive involvement in activities that have high potential for painful consequences
Mood disturbance is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic, and the change in functioning is observable by others.	Mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning.