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Manic Episode

DSM-5 criteria - distinct period of abnormally elevated/irritable mood and increased energy.

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1 What is the Manic Episode?

The Manic Episode is a psychosocial scoring tool used in paediatric practice. DSM-5 criteria - distinct period of abnormally elevated/irritable mood and increased energy. It scores 7 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in psychosocial
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 7 criteria: Inflated self-esteem or grandiosity; Decreased need for sleep (rested after 3 hours); More talkative than usual or pressure to keep talking; Flight of ideas or racing thoughts; Distractibility; Increase in goal-directed activity or psychomotor agitation; Excessive involvement in activities with high risk of painful consequences. Totals are then banded: any score - Below threshold: fewer than 3 symptoms in the mood period; 3 criteria met or more - Threshold met: ≥3 symptoms (≥4 if mood is only irritable) during ≥1 week of elevated mood and increased energy - manic episode. Urgent psychiatric referral.
  • DSM-5 threshold: 3 or more of the 7 criteria listed.
  • A diagnosis also requires clinically significant distress or impairment, the required duration, and exclusion of substance use or another condition. Screening aid only - not a diagnosis.
  • Mania: ≥1 week (or any duration if hospitalisation needed). Hypomania: ≥4 consecutive days without marked impairment or psychosis.
  • If mood is irritable rather than elevated, 4 symptoms are required.

4 Frequently asked questions

How many criteria does the Manic Episode use?

7. They are Inflated self-esteem or grandiosity; Decreased need for sleep (rested after 3 hours); More talkative than usual or pressure to keep talking; Flight of ideas or racing thoughts; Distractibility; Increase in goal-directed activity or psychomotor agitation; and others.

What do the bands of the Manic Episode mean?

The total is interpreted as: any score - Below threshold: fewer than 3 symptoms in the mood period; 3 criteria met or more - Threshold met: ≥3 symptoms (≥4 if mood is only irritable) during ≥1 week of elevated mood and increased energy - manic episode. Urgent psychiatric referral.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

DSM-5 threshold: 3 or more of the 7 criteria listed.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

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For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.