Bipolar and Related Disorder Due to Another Medical Condition 147
ship. Finally, the condition may remit before or just after the medi cal condition remits,
particularly when treatment of the ma nic/hypomanic symptoms is effective. 
Culture-Related Diagnostic Issues
Culture-related differences, to the extent that  there is any evidence, pertain to those asso-
ciated with the medical condition (e.g., rates of multiple sclerosis and stroke vary around
the world based on dietary, genetic fact ors, and other environmental factors).
Gender-Related Diagnostic Issues
Gender differences pertain to those associat ed with the medical condition (e.g., systemic
lupus erythematosus is more common in fema les; stroke is somewhat more common in
middle-age males compared with females).
Diagnostic Markers
Diagnostic markers pertain to those associated with the medical condition (e.g., steroid
levels in blood or urine to help corroborate the diagnosis of Cushing’s disease, which can
be associated with manic or depressive synd romes; laboratory test s confirming the diag-
nosis of multiple sclerosis).
Functional Consequences of Bipolar and Related 
Disorder Due to Anot her Medical Condition
Functional consequences of the bipolar sy mptoms may exacerbate impairments associ-
ated with the medical condit ion and may incur worse outcom es due to interference with
medical treatment. In general, it is believed, but not established, that the illness, when in-
duced by Cushing’s disease, will not recur if the Cushing’s disease is cured or arrested.
However, it is also suggested, but not establ ished, that mood syndromes, including de-
pressive and manic/hypomanic ones, may be episod ic (i.e., recurring) with static brain in-
juries and other central nervous system diseases.
Differential Diagnosis