Bi-Polar Disorder

Question 1

Bipolar 1

Answer 1

Mania with depression

Question 2

Bipolar 2

Answer 2

Depression with mania (common and serious)

Question 3

Cyclothymia

Answer 3

Mood disorder- emotional mood swings

Question 4

Symptoms of bipolar 1

Answer 4

Irritability, euphoria, grandiose ideas, racing thoughts

Question 5

Symptoms of bipolar 2

Answer 5

At least 1 major episode of depression, at least 1 hypomanic episode

Question 6

Epidemiology of BPD 1 and 2 lifetime prevalence

Answer 6

3.9%

Question 7

Lifetime prevalence of Cyclothymia

Answer 7

4.2%

Question 8

Mean age onset of BPD

Answer 8

25

Question 9

Bipolar disorder is highest comorbidity with what other M.D?

Answer 9

ADHD

Question 10

What does BPD share comorbidity with?

Answer 10

ADHD, Panic attacks, substance abuse

Question 11

Recurrence of BPD

Answer 11

37%

Question 12

Ptps and studies in the systematic review (Cignac, 2015)

Answer 12

8 studies, 734 ptps

Question 13

What did Cignac (2015) systematic review find?

Answer 13

26%: 6 months, 41%: 1 year, 60%: 4 years

Question 14

Suicide rates BPD

Answer 14

50% attempt, 11% complete

Question 15

Risk factors of Suicide in BPD

Answer 15

No sense of future, parents left, social isolation, no employment

Question 16

Predictors of depression

Answer 16

Stressful life events, low social support, expressed emotion, neuroticism, negative cognitive style

Question 17

Explain stressful life events prediction of depression

Answer 17

Johnson and Miller (1997): longer time to recover and more severe

Question 18

Studies on expressed emotion predictor of depression

Answer 18

Miklowitz et al (1998): 360 patients, 1 year follow up, distress in response to critique predicted depression, mania and days in recovery

Miklowitz et al (1998): within 9 months, patients with families with EE relapse 94% vs 17% in low EE

Question 19

Predictors of mania

Answer 19

Manic defence hypothesis, goal disregulation and schedule disruption

Question 20

Treatments of BPD

Answer 20

Pharmacology, psychological interventions, family-focused treatment, CBT, interpersonal and social rhythm therapy (IPSRT)

Question 21

What is the study to compare treatments for BPD?

Answer 21

Systematic treatment enhancing programmes (STEP-BD)

Question 22

What is the manic defence hypothesis?

Answer 22

Based on psychodynamic ideas of defence against negative experiences (Perry, 1986)- discriminators of BPD groups

Question 23

What is the goal disregulation hypothesis?

Answer 23

Excessive focus on goals (Johnson et al, 2000 increased manic episodes after success a lot goal; 2005 increased confidence after false success feedback)

Question 24

Who found that during manic episodes, patients paid less attention to negative stimuli?

Answer 24

Lembke and Ketter (2002)

Question 25

What is the schedule disruption hypothesis?

Answer 25

Events that disrupt routine and sleep precede manic episodes (malkoff-Schwartz et al 2002)

Question 26

What is the pharmacology treatment?

Answer 26

Medications e.g Antipsychotics

Question 27

Who recommends the pharmacology treatment?

Answer 27

APA and NICE (Lehman et al, 2004)

Question 28

What is used in conjunction with antipsychotics?

Answer 28

Stabilisers like Lithium

Question 29

Why is lithium used with antipsychotics?

Answer 29

To inhibit neural activity

Question 30

What is the frontline treatment for prophylaxis of BPD?

Answer 30

Lithium

Question 31

Positives of pharmacology treatment?

Answer 31

Antidepressants effective, non-adherence is low (only 20%)

Question 32

What is the psychological interventions treatment?

Answer 32

Psychoeducation, group intervention and individual intervention

Question 33

What strategies are taught in psychoeducation?

Answer 33

Identify symptoms, increase adherence and reduce risk behaviour

Question 34

Positives of group interventions

Answer 34

Reduces stigma, learn self-care from others, less relapse, multidisciplinary

Question 35

Criticism of group interventions

Answer 35

High drop out rates (30%)

Question 36

Family focused intervention (miklowitz, et al, 2000) includes

Answer 36

Improving knowledge of BPD, reducing EE, enhancing communication, problem-solving training

Question 37

Cognitive behavioural therapy better for which mental disorder?

Answer 37

Depression, can be good for BPD (Scott et al, 2006)

Question 38

Interpersonal and social rhythm therapy

Answer 38

Based on idea that disruption to routine is a risk factor of BPD Teaches skills to stabilise social rhythms e.g. Bedroom for sleeping, dark

Question 39

Positives of IPSRT

Answer 39

Puts control in patients life, Frank et al (2005)- adds clinical management of BPD in management of preventing new episodes

Question 40

Systematic treatment enhancing programmes (STEP BD) results for comparison between psychotherapy and psychointervention.

Answer 40

No difference

Question 41

STEP BD result for comorbidity with anxiety disorder

Answer 41

Did better on intensive psychotherapy (Dekersbach et al, 2014)

Question 42

People with extreme negative attribution did _____ (Strange et al, 2013)

Answer 42

Worse, regardless of treatment

Question 43

DSM 5 (2013) criteria for BPD

Answer 43

Major depressive episodes, manic episodes, mixed episodes, hypo manic episodes