Transtorno bipolar tipo I, atual episódio depressive, grave, com psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I are met and the atual episódio is grave and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).