The final criteria that must be met is that the mood episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (from the depressive symptoms or the unpredictability of cycling between periods of depression and hypomania).A hypomanic episode is established if a patients symptoms last for most of the day each day for at least four days. Furthermore, three or more of the following symptoms must be present: Inflated sense of self-esteem or grandiose thoughts, feeling well rested despite getting low amounts of sleep (3 hours), talkativeness, racing thoughts, distractibility, and increase in goal-directed activity or psychomotor agitation, or excessive involvement in activities with high risk of painful consequences. Per DSM-5 criteria, a major depressive episode consists of the presence of a depressed mood or loss of interest/pleasure in activities (anhedonia). In addition to the former symptoms, five out of the nine following symptoms must occur for more than two weeks (to the extent in which it impairs functioning): weight loss/gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness/inappropriate guilt, decreased concentration, or thoughts of death/suicide.Specifiers:

With current or most recent episode hypomanic or depressed
With partial remission or full remission
With mild, moderate, or severe severity
With anxious distress
With catatonic features
With mood congruent psychotic features
With peripartum onset
With seasonal pattern (applies only to the pattern of major depressive episodes)
With rapid cycling.
A pelvic kidney, also known as an ectopic kidney, is a normal kidney located in the pelvis, instead of the abdomen. This occurs when a kidney does not ascend from its original location in the pelvis to its final location during prenatal development. They usually present no symptoms, but can increase risk of certain illnesses and healthcare problems. Signs and symptoms
Often, a person with a pelvic kidney will go through their whole life not even knowing they have a pelvic kidney. Complications
Typically, the kidney functions normally despite being in the wrong location. However, it can develop complications. A pelvic kidney can make it more difficult to diagnose kidney infections and kidney cancer. The renal artery and the renal vein may be stretched if they remain attached to the normal locations on the abdominal aorta and the inferior vena cava, which can lead to illness. Causes
In the development of the human embryo, the metanephric kidneys fail to ascend and usually remain at the brim of the pelvis. This clinical scenario may present no signs or symptoms and the kidneys may function normally. It is associated at times with Mullerian dysgenesis. Diagnosis
A pelvic kidney is discovered on newborn kidney ultrasound screening. It may also be detected if complications arise later in life for this or a completely different reason, and during investigations. Epidemiology
Between 1 in 2,200 and 1 in 3,000 people may have a pelvic kidney. History
A pelvic kidney is also known as an ectopic kidney. == References ==