Bipolar 1 Flashcards
What is the difference between bipolar 1 and bipolar 2
- Bipolar 1 is manic and mixed
- Bipolar II is hypomanic
(both are depressed)
What are the bipolar disorders (4)
- Bipolar 1
- Bipolar 2
- Cyclothymic disorder
- Bipolar NOS
What is a very general definition of bipolar disorder?
Cycling of moods
Define bipolar 1
One manic or mixed episode
(do not need to have a depressive episode, though it is likely)
Define bipolar 2
One or more major depressive episode accompanied by one hypomanic episode
Define cyclothymic disorder
At least 2 years of numerous periods of hypo Manic and depressive symptoms
(Beyond his normal cycling)
Define bipolar disorder not otherwise specified (NOS)
Cycling episodes but do not meet the other criteria
Prevalence of bipolar disorder
- Bipolar I: 1.7%
- Bipolar II: 0.5 to 2%
- Bipolar spectrum disorder: 3 to 6.5%
(female predominance)
Bipolar disorder is usually diagnosed at what age?
Early twenties
(genetic component)
Mnemonic for Mania, Hypomania or Mixed episodes
DIGFAST
- Distractibility
- Indiscretion (excessive involvement in pleasurable activities)
- Grandiosity
- Flight of Ideas
- Activity increase
- Sleep deficit
- Talkativeness (pressured speech)
(mania & hypomania both need at least 3 of DIGFAST sx, 4 if irritable)
What is the difference between bipolar manic, hypomanic and mixed episodes?
- manic: 1 week + emphasis on goal-oriented energy
- hypomanic: 4 days
- mixed: 1 week of DIGFAST + MDD
(mania & hypomania both need at least 3 of DIGFAST sx, 4 if irritable)
Manic episodes may NOT be caused by:
- substance
- medical condition
- meet criteria of mixed episode
(hypomania also may NOT be caused by substances or medical conditions)
For both manic & mixed episodes, the symptoms are persistant for one week and severe enough to cause one or more of the following three immediate outcomes.
- Impairment in occupational functioning, social activity or relationships
- Hospitalization
- Psychotic feature
DSM-5 criteria for mixed episodes (2)
Manic episodes and major depressive episode for one week
May cause one of the following:
- impairment in occupation, social activity or relationships
- hospitalization to prevent from harm to self or others
- psychotic features
(manic episodes may also result in one of the three immediate outcomes listed)
Define Rapid Cycling
>/= 4 episodes of depression, mania, mixed, or hypomania in previous 12 months
Rapid Cycling specifier episodes are demarcated by
- Full or partial remission for 2 months
Or
- Switch to an episode of opposite polarity
(distinct course modifier associated with poor clinical outcome)
Rating scales & screening instruments for bipolar (3)
- Mood disorder questionnaire (MDQ)
- Mood charting (image or use notebook)
- Young Mania Rating Scale
How many doctors do patients with bipolar disorder see before they get a correct diagnosis?
4
Bipolar disorder is most likely misdiagnosed as ______ (4)
- depression
- anxiety disorder
- schizophrenia
- borderline personality (mood swings) or antisocial
What is the main difference between borderline personality and bipolar cycling?
- Personality disorder: cycle through one day
- Bipolar: cycles over the course of one week
Onset of the first manic episode after the age of 40 is a red flag to consider _____ (2)
- Substance use
- General medical condition (brain tumor)
Seasonal variation of bipolar disorder (2)
- Depression : MC in spring and autumn
- Mania: MC in summer
(may have to do with sun exposure)
Genetic component of bipolar disorder
(don’t mem the chromo. this is always changing)
What is the difference between MDD & a depressive episode of bipolar disorders?
They both have SIG:ECAPS symptoms, the difference is that bipolar cycles between thsoe symptoms and manic, hypomanic or mixed episodes
