Which bipolar specifier indicates psychotic features during a manic episode?

• A. With psychotic features, manic
• B. Unspecified
• C. In partial remission, depressed
• D. With anxious distress

Answer: (A)

The concept tested is how psychotic symptoms are labeled when they occur during a mood episode in bipolar disorder. When psychotic features accompany a manic episode, the correct specifier is “with psychotic features,” applied to the manic episode. This indicates delusions or hallucinations are present specifically during the mania, guiding treatment decisions (often needing both a mood stabilizer and an antipsychotic) and informing prognosis.

The chosen phrasing, “with psychotic features, manic,” precisely communicates that psychosis occurs during the manic phase. Other options don’t fit: “unspecified” doesn’t indicate psychosis; “in partial remission, depressed” refers to remission status of a depressive episode, not mania or psychosis; and “with anxious distress” denotes anxiety symptoms, not psychotic features.