juries and other central nervous system diseases.
Differential Diagnosis
Symptoms of delirium, catatonia, and acute anxiety. It is important to differentiate
symptoms of mania from excite d or hypervigilant delirious symptoms; from excited cata-
tonic symptoms; and from agitation related to acute anxiety states. 
Medication-induced depre ssive or manic symptoms. An important differential diag-
nostic observation is that the other medica l condition may be treated with medications
(e.g., steroids or alpha-interferon) that can induce depressive or manic symptoms. In these
cases, clinical judgment using all of the eviden ce in hand is the best way to try to separate
the most likely and/or the most important of two etiological factors (i.e., association with
the medical condition vs. a substance/medicati on-induced syndrome). The differential di-
agnosis of the associated medical conditions is relevant but largely beyond the scope of the
present manual. 
Comorbidity
Conditions comorbid with bipolar and relate d disorder due to anot her medical condition
are those associated with the medical conditio ns of etiological relevance. Delirium can oc-
cur before or along with manic symptoms in individuals with Cushing’s disease.