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PSYCHIATRY > Abnormal Mood - Elated > Flashcards

Abnormal Mood - Elated Flashcards

1
Q

How do the DSM-5 and ICD-10 differ in their classification of bipolar disorder?

A

DSM-5 - classifies according to course and pattern
=> Bipolar I and II
=> Cyclothymic disorder

ICD-10 - classifies according to severity
=> Hypomania
=> Mania +/- psychotic features

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2
Q

What is the main difference between Bipolar disorders 1 and 2?

A

Bipolar 1 - patient has met manic criteria and has experienced hypomania or depressive episode in the past

Bipolar 2 - Patient has experienced hypomanic and depressive episode but has NEVER met criteria for mania

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3
Q

Which of Bipolar I and II is more common?

A

Bipolar II

around 2/3

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4
Q

What is thought to cause Bipolar III?

A

Hypomanic episodes only occur following use of antidepressants for depression

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5
Q

Give examples of symptom “specifiers” found in the DSM-5 classification?

A
  • with anxiety features
  • with melancholic features
  • with mixed features
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6
Q

A single episode of hypomania or mania shifts the diagnosis to bipolar disorder, regardless if patient has not had a depressive episode yet. TRUE/FALSE?

A

TRUE

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7
Q

Why is important to differentiate depression from bipolar disorder?

A

Management plan = different

Bipolar disorder patients should not be given anti-depressants alone as this can make them worse

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8
Q

What is hypomania?

A

Hypo= below

=> hypomania means a level of disturbance below mania

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9
Q

What symptoms indicate a hypomanic episode?

A
  • mood is elevated/irritable to an abnormal degree for at least 4 consecutive days

PLUS 3 impairing daily function:

  • increased activity/restless
  • increased talkativeness
  • Poor concentration
  • decreased need for sleep
  • increased sexual energy
  • spending spree/irresponsible behaviour
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10
Q

What symptoms would indicate a manic episode?

A
  • Mood elevated/ irritable and abnormal for at least 1 week

PLUS 3 severely impairing daily function:

  • Increased activity/restless
  • ‘pressured’ speech
  • Flight of ideas/ thoughts racing
  • disinhibited in inappropriate social situations
  • Decreased need for sleep
  • Inflated self-esteem/grandiosity
  • constant changes in activity/plans
  • Reckless behaviour
  • Marked sexual energy
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11
Q

Describe the Appearance and Behaviour of a patient with Bipolar disorder during an MSE?

A

Bright clothes
Distractibility
Loss of normal social inhibitions / overfamiliarity

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12
Q

Describe the speech of a patient with Bipolar disorder during an MSE?

A 
Increased talkativeness (hard to interrupt) 
Punning
Clang associations (similar sounding words - almost rhyme)
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13
Q

Describe the thoughts of a patient with bipolar disorder during an MSE?

A
  • Increased flow (lots of thoughts)
  • Flight of ideas and loosening of associations
  • Grandiosity
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14
Q

When is the typical onset for bipolar disorder?

A

Onset usually in late teens, or early 20’s

10yrs earlier than depression

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15
Q

A family history of Bipolar disorder often results in earlier onset. TRUE/FALSE?

A

TRUE

AND episodes are precipitated by lower levels of stress

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16
Q

What other co-morbid disorders can commonly be present with bipolar disorder?

A 
Anxiety disorders
Alcohol and drug misuse 
Personality disorders (esp. borderline personality disorder) 
Eating disorders 
Schizoaffective disorder 
Schizophrenia
17
Q

Aside from bipolar disorder, what other mental disorders show that genetic links potentially play a part?

A

Schizophrenia

some of these genetic links can predispose to BOTH disorders

18
Q

Why is it difficult for patients with bipolar disorder to plan ahead in their daily life?

A

What mood they will be in on the day is unknown to them when planning

19
Q

What percentage of patients with bipolar disorder are symptomatic at any one time?

A

around 50% symptomatic

Slightly more in Bipolar II than in Bipolar I

20
Q

Depression is the most common mood disturbance experienced in bipolar disorders. TRUE/FALSE?

21
Q

What symptom of bipolar disorders cause the most impact on function? And how is this treated?

A

Depressive episodes affect function most
=> antidepressants don’t work well (can precipitate mania/hypomania)
=> mood stabilisers more useful

22
Q

What theories try to explain the higher rate of suicide in Bipolar disorder compared to other mental health disorders?

A
  • impulsivity

- very large difference between highs (mania) and lows (depression)

23
Q

What is Mixed Affective state?

A
  • quick transition from hypomanic/manic to depressive episode in Bipolar Affective Disorder
  • rather than normal discrete episodes of depression/mania
  • Patient describes themself as having been fine, but symptoms of depression are beginning to appear
  • Patient appears anxious, fidgety, restless

PSYCHIATRY (35 decks)

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