30th April 2024

A 30-year-old woman presents with a 1-month history of decreased need for sleep, increased energy, and heightened irritability.

A 30-year-old woman presents with a 1-month history of decreased need for sleep, increased energy, and heightened irritability. She reports feeling “on top of the world” and more productive than usual. However, her family notes that she has been making impulsive decisions, such as spending large amounts of money and starting multiple new projects without finishing them. She has a past medical history of depression and was previously treated with sertraline, which she discontinued six months ago. She denies any substance use or significant medical history.

Investigations:

General Appearance: Energetic, pressured speech

Mental Status Examination: Grandiose ideas, distractible, increased psychomotor activity

Which test is most likely to assist in confirming the diagnosis of bipolar affective disorder?