[Is it all bipolar? Differential diagnosis of mood swings in young adulthood].

BACKGROUND

Mood swings can represent a key symptom of various psychiatric disorders in young adulthood. Due to substantial symptom overlap, clinicians often face diagnostic uncertainty, increasing the risk of misdiagnosis and inappropriate treatment.

OBJECTIVES

Description of qualitative and quantitative characteristics of mood swings in the most relevant psychiatric disorders.

MATERIALS AND

METHODS

Narrative review based on the International Classification of Diseases, 11th Revision (ICD-11) and pertinent literature.

RESULTS

Bipolar affective disorders exhibit episodic, mostly non-reactive mood swings in clearly defined temporary episodes. In unipolar depression, affective changes are predominantly downward-directed and may show diurnal variation. Emotionally unstable personality disorder is characterized by high-frequency, reactive, and interpersonally triggered affective states, whereas neurodevelopmental disorders typically present with situationally induced, short-lived emotional dysregulation.

CONCLUSIONS

Differential diagnostic evaluation requires a comprehensive clinical assessment, possibly supported by life charts, mood diaries, or psychometric instruments. Given the frequent comorbidities and symptom overlap, a longitudinal diagnostic approach is recommended in cases of uncertainty.