Associated descriptive features and mental disorders. Completed suicide (usually during Major Depressive Episodes) is a significant risk, occurring in 10%-15% of persons with Bipolar II Disorder. School truancy, school failure, occupational failure, or divorce may be associated with Bipolar II Disorder. Associated mental disorders include Substance Abuse or Dependence, Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit/Hyperactivity Disorder, Panic Disorder, Social Phobia, and Borderline Personality Disorder.
Associated laboratory findings. There appear to be no laboratory features that are diagnostic of Bipolar II Disorder or that distinguish Major Depressive Episodes found in Bipolar II Disorder from those in Major Depressive Disorder or Bipolar I Disorder.
Associated physical examination findings and general medical conditions. An age at onset for a first Hypomanic Episode after age 40 years should alert the clinician to the possibility that the symptoms may be due to a general medical condition or substance use. Current or past hypothyroidism or laboratory evidence of mild thyroid hypofunction may be associated with Rapid Cycling. In addition, hyperthyroidism may precipitate or worsen hypomanic symptoms in individuals with a preexisting Mood Disorder. However, hyperthyroidism in other individuals does not typically cause hypomanic symptoms.