Abnormal mood - elevated Flashcards
Describe Bipolar I
Bipolar I = patient has to have met the criteria for mania at some point, although previous episodes may have been hypomanic &/or depressive
Most people will have had episodes of major depression but can sometimes only have manic episodes
Describe Bipolar II?
Patient has has episodes of hypomania and episodes of depression but HAS NOT had an episode of mania
Describe Bipolar III?
This is also called ‘pseudo-unipolar’ and is where hypomanic episodes only occur fallowing the use of anti-depressants for depression
Describe the classification of bipolar affective disorder
This is classified as > or equal to 2 episodes in which the patients mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of hypomania or mania and on others depression
(need both the high and low for it to be classified as this)
If a patient has only repeated episodes of hypomania or mania (no episodes of depression) then what is this classified as ?
Simply bipolar
How do you differentiate between bipolar disorder and depression?
- A single episode of hypomania or mania = bipolar disorder (not bipolar affective disorder unless had episodes of depression)
- The 1st episode of hypo(mania) in someone with depression = bipolar affective disorder, not depression anymore
Define a hypomanic episode
The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least 4 consecutive days
At least three of the following signs must be present, leading to some interference with personal functioning in daily living:
Increased activity or physical restlessness;
- increased talkativeness;
- difficulty in concentration or distractibility;
- decreased need for sleep;
- increased sexual energy;
- mild spending sprees, or other types of reckless or irresponsible behaviour;
Define a manic episode
Mood must be predominantly elevated, expansive or irritable, and definitely abnormal for the individual concerned. The mood change must be prominent and sustained for at least 1 week (unless it is severe enough to require hospital admission)
At least three of the following signs must be present (four if the mood is merely irritable), leading to severe interference with personal functioning in daily living:
- Increased activity or physical restlessness;
- Increased talkativeness (‘pressure of speech’);
- Flight of ideas or the subjective experience of thoughts racing;
- Loss of normal social inhibitions resulting in behaviour which is inappropriate to the circumstances;
- Decreased need for sleep;
- Inflated self-esteem or grandiosity
- Distractibility or constant changes in activity or plans
- Behaviour which is foolhardy or reckless and whose risks the subject does not recognize e.g. spending sprees, foolish enterprises, reckless driving
- Marked sexual energy or sexual indiscretions.
What are the key signs to look out for indicating someone is manic ?
- grandiose
- flight of ideas - a rapid flow of thought, manifested by accelerated speech with abrupt changes from topic to topic
- complete loss of social norms like exposing yourself rather than chatting up people constantly.
Define a hallucination
Can be auditory (most common), visual, gustatory, (taste), or tactile (touch sensation) without any stimulus
What are hypngogic/hypnopompic hallucinations and are these pathological ?
When you experience a hallucination when falling asleep or waking
These are not pathological
Define a dellusion
Beliefs that are held unshakably by the patient, irrespective of counter-arguments given
Mania can occur with out without psychotic symptoms - T or F?
True
What would suggest mania with psychotic symptoms and how does these psychotic symptoms differ from schizophrenia ?
Dellusions/ hallucinations are present, but the delusions are not completely impossible or culturally inappropriate i.e. they make some sense;
- There hallucinations are not in the 3rd person or giving a running commentary
- Commonest examples of delusions are those with grandiose, self-referntial (about themselves), erotic or persectutory (believe there being persecuted)
Unlike the ones in schizophrenia to do with alients/CIA etc
Note in mania without psychotic symptoms they may have subjective hyperacusis (increased sensitivity to certain sounds and frequencies), and there appreciation of colour may be esp vivid
When does bipolar (which isn’t caused by an organic cause) disorder usually arise ?
In late teens early 20s
