Rosh Psychiatry Board Practice Exam

A 30-year-old woman reports episodes of increased energy and decreased need for sleep. What is the most likely diagnosis?

1. Bipolar I disorder

2. Attention deficit hyperactivity disorder

3. Cyclothymic disorder

4. Bipolar II disorder

The correct answer is: Bipolar II disorder

In considering the symptoms presented by the woman, including increased energy and decreased need for sleep, these are characteristic features of a manic or hypomanic episode, which are key components of bipolar disorders. While both Bipolar I and Bipolar II disorders involve these symptoms, the distinction lies in the severity of the episodes. Bipolar I disorder is marked by the presence of at least one manic episode, which is more severe and may include psychotic features or significant impairment in functioning. In contrast, Bipolar II disorder is characterized by the presence of at least one hypomanic episode and one major depressive episode, with hypomania being less severe than mania and not leading to the same level of functional impairment. In this scenario, since the symptoms of increased energy and decreased need for sleep have not been described as severely impairing the individual’s ability to function, the most fitting diagnosis is Bipolar II disorder, where the episodes may not require hospitalization and do not result in major impairments compared to episodes of Bipolar I disorder. Cyclothymic disorder involves numerous periods of hypomanic symptoms and periods of depressive symptoms that do not meet the criteria for a major depressive episode, which is not indicated in this case. Attention-deficit hyperactivity disorder