Bipolar Flashcards
Symptoms of hypomania
- at least 4 days
- can be functional
- elated mood
- increased energy
- increased self esteem
- increased sociability
- pressured speech
- increased sex drive
- reduced need for sleep
- difficulty focussing
Symptoms of mania
- at least 1 week
- not functional
- elated mood
- increased energy
- grandiose delusions
- pressure of speech
- flight of ideas
- distractible
- Insomnia
- increased libido
- lack of social inhibitions
- psychotic symptoms
Biopsychosocial management of bipolar
Biological:
- admission dependent on risk
- bloods - rule out organic cause
- 1st line - atypical antipsychotic
- 2nd line once stabilised - mood stabiliser
- can also give benzodiazepines when unstable
- avoid anti depressants
Psychological:
- psychoeducation
- bipolar specific CBT
- CMHT
- CPN
Social:
- social prescribing
Classifications of bipolar affective disorder
Type I - manic episode/ mixed episode + depressive episode
Type II - hypomania episode + depressive episode
Epidemiology of bipolar
1 - 2% prevalence
Median age of onset - 25 yrs old
Suicide rate - 20 x more likely
Differential diagnosis
PTSD
Cyclothymia
Drug induced psychosis
Alcohol intoxication
Cyclothymia
Mild periods of elation or depression
Early onset or chronic douse
Common in relatives of BPD
Dysthymia
Chronic low mood not fulfilling the criteria for depression
Mixed affective disorder
Either rapid alternations, usually within a few hours of hypomania, mania or depressive symptoms
Or
A mixture of hypomania, mania or depressive symptoms
Factors that suggest a poor prognosis of bipolar
- severe episodes
- early onset
- cognitive deficits
Bipolar CT scan
Enlarged lateral ventricles
Enlarged amygdala
Reduced left prefrontal grey matter volume
Risk factors of bipolar
Male Depressed Previous self harm Substance misuse Living alone Socially isolated
