Cyclothymic disorder

Cyclothymic disorder is a chronic mood disturbance characterized by numerous periods of hypomanic symptoms and numerous periods of depressive symptoms, neither of which meet the full criteria for a hypomanic episode or a major depressive episode, respectively. These mood fluctuations are less severe than those seen in bipolar I or II disorder but are persistent and cause significant distress or impairment. The condition typically begins in adolescence or early adulthood and has a chronic course.

This code is appropriate when documentation indicates a persistent, fluctuating mood disturbance with symptoms of both hypomania and depression that do not meet the diagnostic criteria for a full manic, hypomanic, or major depressive episode. Use when the patient experiences these symptoms for at least two years (one year for children/adolescents) and has not been symptom-free for more than two consecutive months during that period. Supporting documentation should clearly outline the chronic nature and subthreshold symptomology.

• Differentiate from Bipolar II disorder (F31.81) where full hypomanic episodes and major depressive episodes occur.
• Ensure the documentation specifies the chronic, fluctuating nature of symptoms and that they do not meet full criteria for other mood disorders.
• Consider sequencing this code as a primary diagnosis when it is the focus of the encounter, or as a secondary diagnosis if another condition is the primary reason for the visit.