Affective Disorders - Bipolar

Question 1

What is mania?

Answer 1

Typically considered as a form of pathological, inappropriate elevated mood.

Question 2

What is mania often associated with?

Answer 2

• Grandiose ideas
• Disinhibition
• Loss of judgement
• Similarities to the mental effects of stimlant drugs

Question 3

What is hypomania?

Answer 3

• A lesser degree of mania
• Psychosis is abscent

Question 4

What is the ICD10 criteria for hypomania?

Answer 4

• Lesser degree of mania, no psychosis
• Mild elevation of mood for several days on end
• Increased energy and activity, marked feeling of wellbeing
• Increased sociability, talkativeness, overfamiliarity, increased sexual energy, decreased need for sleep
• May be irritable
• Concentration reduced, new interests, mild overspending
• Not to the extent of severe disruption of work or social rejection

Question 5

What is the ICD10 criteria for mania?

Answer 5

• 1 Week, severe enough to disrupt ordinary work and social activities more or less completely
• Elevated mood, increased energy, overactivity, pressure of speech, decreased need for sleep
• Disinhibition
• Grandiosity
• Alteration of senses
• Extravagant spending
• Can be irritable rather than elated

Question 6

Differential diagnosis for mania.

Answer 6

• Psychiatric
  
  • Mixed affective state
  • Schizoaffective disorder
  • Schizophrenia
  • Cyclothymia
  • ADHD
  • Drugs and Alcohol
• Medical
  
  • Neurological - Stroke, MS, Tumour, epilepsy, AIDS, Neurosyphilis
  • Endocrine – Cushing’s, hyperthyroidism
  • Systemic lupus erythematosus

Question 7

Measurement tools for mania.

Answer 7

• SCID
• SCAN
• Young mania rating scale (YMRS)

Question 8

Treatment options for mania.

Answer 8

• Antipsychotics
• Mood stabilisers
• ECT

Question 9

What is bipolar disorder?

Answer 9

• A condition that consists of repeated (2+) episodes of depression and mania or hypomania

Question 10

Epidemiology of major depression.

Answer 10

• Lifetime prevalence 2.9-12%
• F:M 2:1
• Mean age of onset = 27

Question 11

What is the typical outcome of major depression?

Answer 11

• typical episode lasts 4-6 months
• 12% fail to recover
• 80+% have further episodes
• 15% die by suicide

Question 12

Epidemiology of bipolar disorder/mania.

Answer 12

• Lifetime prevalence 0.7-1.6%
• M=F
• Mean age of onset = 21

Question 13

Typical outcome of bipolar disorder/mania

Answer 13

• typical manic episode lasts 1-3 months
• 5% fail to recover
• 90% have further episodes
• 10% die by suicide