In addition to the presence of a distinct period of abnormally and persistently elevated, expansive or irritable mood with abnormally and persistent increased goal-directed activity lasting at least one week and 3 or more of the diagnostic manic symptoms. A patient must also have all of the following EXCEPT what?
a) Mood disturbance causes marked impairment in social or occupational functioning and/or necessitate hospitalization
b) The episode is NOT attributable to the psychologic effects of a substance or there are psychotic features
c) The patient must have a previous diagnosis of depression
Answer: C
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