Bipolar Affective Disorder vs. Bipolar Disorder: Terminology Clarification
There is no clinical difference between "bipolar affective disorder" and "bipolar disorder"—these are simply two names for the same condition. The term "bipolar affective disorder" is the formal nomenclature used in ICD-10, while "bipolar disorder" is the preferred term in DSM-5 and ICD-11, reflecting a shift toward simplified diagnostic terminology 1.
Why Two Names Exist
ICD-10 used "bipolar affective disorder" as part of its classification system that grouped conditions under "mental and behavioral disorders" with descriptive modifiers like "affective" 1.
DSM-5 and ICD-11 harmonization efforts led to the adoption of the simpler term "bipolar disorder" without the "affective" qualifier, streamlining international diagnostic communication 1.
Both terms describe the identical clinical entity: a severe mental illness characterized by recurrent episodes of mania or hypomania alternating with depression 2, 3.
Clinical Definition (Regardless of Name Used)
Bipolar I disorder requires at least one manic episode lasting ≥7 days (or any duration requiring hospitalization), with depressive episodes not required for diagnosis 4.
Bipolar II disorder is defined by at least one hypomanic episode (≥4 days) and at least one major depressive episode, with no history of full mania 1, 4.
Core features include distinct periods of abnormally elevated, expansive, or irritable mood with increased energy, decreased need for sleep, racing thoughts, pressured speech, grandiosity, and excessive involvement in pleasurable activities with high potential for consequences 4.
Practical Implications
Documentation and coding: When using ICD-10 systems, you may encounter "bipolar affective disorder" in medical records, insurance claims, or international literature 1.
No treatment differences: The terminology variation has zero impact on clinical management—lithium, valproate, lamotrigine, and atypical antipsychotics remain first-line treatments regardless of which name is used 3.
Literature searches: When reviewing research, search both terms to capture all relevant studies, as older publications (especially from ICD-10 era) predominantly use "bipolar affective disorder" 2, 5.
Common Pitfall to Avoid
- Do not assume "affective" implies a different subtype or severity—this is purely a nomenclature difference between classification systems, not a clinical distinction 1. The pathophysiology, diagnostic criteria, treatment approach, and prognosis are identical whether the condition is labeled "bipolar disorder" or "bipolar affective disorder" 3, 5.