Affective Disorders - Mania/Bipolar

Question 1

What is mania?

Answer 1

State of elevated feeling/mood ranging from near-normal to severe/life-threatening

Question 2

What happens to a person with mania?

Answer 2

Grandiose ideas
Dis-inhibition
Loss of judgement

Question 3

What drugs can lead to similar effects of mania?

Answer 3

Stimulants like cocaine

Question 4

Mania is considered a form of…

Answer 4

Pathological, inappropriate elevated mood

Question 5

Since there is no clear division between mania and normal elevated mood, psychiatry places emphasis on…

Answer 5

Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Presence of specific symptoms or signs

Question 6

What is hypomania?

Answer 6

Lesser degree of mania with no psychosis

• mild elevation of mood for several days
• increase in energy, activity, sociability, libido
• mild increase in spending
• decrease in sleep, concentration
• may be irritable

All this is not severe enough to disrupt work or lead to social rejection

Question 7

List the features of mania.

Answer 7

Elevated mood for 1 week severe enough to disrupt work and social activities

• Increase in energy, over-activity
• Dis-inhibition
• Grandiosity
• Alteration of senses
• Overspending
• Irritable rather then elated
• Decreased need for sleep

Question 8

What is dis-inhibition?

Answer 8

A lack of restraint shown in a general disregard of social conventions
Increased impulsiveness and poor risk assessment

Question 9

Mania psych differentials?

Answer 9

Mixed affective state
Schizo-affective disorder
Schizophrenia
Cyclothymia
ADHD 
Drug and alcohol abuse

Question 10

What is cyclothymia?

Answer 10

Not full blown bipolar disorder but experiencing mild depression and then periods of hypomania

Question 11

Mania medical differentials?

Answer 11

Neuro - stroke, MS, epilepsy, neurosyphilis
Endo - cushings, hyperthyroidism
SLE
AIDS

Question 12

Diagnostic tools for mania?

Answer 12

SCID
SCAN
Young Mania Rating Scale

Question 13

Mania treatment?

Answer 13

Antipsychotics
Mood stabilisers
Lithium
ECT

Question 14

List some anti-psychotics

Answer 14

Olanzapine
Quetiapine
Risperidone

Question 15

List some mood stabilisers.

Answer 15

Sodium Valproate
Carbamazepine
Lamotrigene

Question 16

What is bipolar affective disorder?

Answer 16

Classed as a disorder with repeated (2+) episodes of depression and mania/hypomania

Question 17

What is the diagnosis if there is repeated episodes of depression with no mania/hypomania?

Answer 17

Recurrent depression

Question 18

If no depression the diagnosis is

Answer 18

Hypomania or bipolar disorder

Question 19

In DSM-5 BLANK episode(s) of mania is sufficient to diagnose bipolar disorder.

Answer 19

A single episode of mania

Question 20

Typical manic episode in bipolar lasts?

Answer 20

1 to 3 months

Question 21

?% recovered at 10 weeks

Answer 21

60%

Question 22

?% fail to recover.

Answer 22

5%

Question 23

?% have further bipolar episodes.

Answer 23

90%

Question 24

?% die by suicide

Answer 24

10%

Question 25

Epidemiology of bipolar - is it more prevalent in industrialised nations or non-industrialised?

Answer 25

Rate is equal

Question 26

Epidemiology of bipolar - rates for males and females?

Answer 26

Rate is equal

Question 27

Mean age of onset?

Answer 27

21

Question 28

Is there a difference in prevalence when looking at income, occupation or educational status?

Answer 28

No