Bipolar Flashcards
Define bipolar one disorder
At least one episode mania. Major depressive or hypomanic episodes usually also occur.
Define bipolar 2
At least 1 episode hypomania and one depressive episode. No previous mania!
Define cyclothymic disorder and conditions for diagnosis (4)
Chronic, fluctuating mood disturbance involving numerous episodes hypomanic episodes and periods MINOR depressive symptoms . “Mild” bp 2. For 2 or more years (1 in children), where the hypomanic and depressive periods present for at least half the time. Individual not without symptoms for more than 2 months.
Don’t meet full criteria for hypomania and mde
Define rapid cycling
More than or equal to four depressive/manic episodes in 1 year.
Mean age onset of bipolar disorders?
1: 18
2: 20
Which 3 hormones are theorised to play a part in bipolar?
- NorAdrenalin and serotonin mostly (decreased ) esp depression
- Also dopamine. Increased in mania, decreased in depression.
What are the 2 key differences between mania and hypomania?
1 mania for at least 1 week or any duration if hospitalisation required • hypo-mania at least 4 consecutive days but less than week
2. Mania marked impairment, hypomania not as much.
Name 7 symptoms of mania. How many need to make diagnosis?
DIG FAST Distractibility Impulsivity and indiscretion Grandiosity Flight of ideas Activity increased: sexually/at work/socially. Or psychomotor agitation Sleep deficit Talkativeness Need 3 or more to diagnose.
Define manic episode length
1 week
Define hypomanic episode length
4 consecutive days to 6 days ( from 1 week-mania)
Mania vs hypomania? (4)
- Extreme symptoms (eg psychosis) vs less extreme
- 1 week vs 4 consecutive days
- symptom of bipolar 1 vs 2
- marked impairment in socio - occupational function, often require hospitalisation vs not severe
Name 4 presentations that fall under other specified bipolar and related disorder
- Short duration hypomanic episodes (2-3 days) and major depressive episodes
- hypomanic episodes with insufficient symptoms and major depressive episodes
- hypomanic episode without prior major depressive episode
- short duration cyclothymia (<2 years)
Define full remission for bipolar
Symptomless > 2 months
Name 18 specifiers bipolar
- With anxious distress
- with mixed features
- with rapid cycling
- with melancholic features (NOT bipolar 2)
- with atypical features (NOT bipolar 2)
- with mood-congruent psychotic features
- with mood-incongruent psychotic features
- with Catatonia
- with peripartum onset
- with seasonal pattern
- mild
- moderate
- severe
- in partial remission
- in full remission
- unspecified
Bipolar 2: specify current / most recent episode as hypomanic/ depressed
When use specifier “with anxious distress” for bipolar / depression (5)
At least 2:
- feel keyed up or tense
- unusually restless
- difficulty concentrating due to worry
- fear something awful might happen
- feel might lose control
Mild: 2
Moderate: 3
Moderate - severe: 4-5
Severe: 4-5 + motor agitation
When use specifier “manic or hypomanic episode, with mixed features “ for bipolar (6)
At least 3:
- dysphoria/depressed
- anhedonia
- psychomotor retardation
- fatigue / energy loss
- feel worthless/guilt
- recent thoughts of death/suicide/ attempt/plan
If symptoms meet full episode criteria for both mania + depression at same time, make this diagnosis,
When use specifier “ depressive episode, with mixed features “ for bipolar (6)
Full criteria met for depressive episode and 3 manic/hypomanic symptoms
If meet all criteria mania, diagnose as manic episode with mixed features
When use specifier “with melancholic features “ for bipolar /depression (8)
A.at least 1:
- anhedonic,
- lack reactivity to usually pleasurable stimuli
B.at least 3:
- depressed mood: profound despondency, despair, moroseness, empty mood
- depression regularly worse in morning
- early morning awakening
- psychomotor agitation/retardation
- anorexia / weight loss
- guilt
When use specifier “with atypical features “ for bipolar depressive episode /depression (6)
A. Mood reactivity: mood brightens in response to positive event
B. 2 or more
- weight gain/appetite increase
- hypersomnia
- leaden paralysis
- long-standing pattern of interpersonal rejection sensitivity
C. Criteria not met for melancholic features or Catatonia
Name 7 bipolar and related disorders
- Bipolar 1 disorder
- bipolar 2
- cyclothymic (2 years adult, 1 children)
- ” substance/medication “ induced bipolar and related disorder
- bipolar and related disorder due to “another medical condition “
- other specified bipolar and related disorder, reason
- unspecified bipolar and related disorder
Name 8 depressive disorders
- Disruptive mood dysregulation disorder (age 6-10, 3 or more outbursts/ week for 1 year)
- major depressive ( 2 weeks)
- persistent depressive (2 years)
- premenstrual dysphoric disorder (1 - year)
- “substance/medication” induced depressive disorder
- depressive disorder due to “ AMC”
- other specified depressive disorder, reason
- unspecified depressive disorder
Name 11 anxiety disorders
- Separation anxiety disorder (children 4 weeks, adults 6 months)
- specific phobia (6 mo)
- selective mutism (1 mo)
- agoraphobia (6 mo)
- social anxiety disorder ( 6 mo)
- panic disorder (1 mo)
- generalised anxiety disorder ( 6 mo)
- ”s/m -I” anxiety disorder
- anxiety disorder due to “AMC”
- other specified anxiety disorder, reason
- unspecified anxiety disorder
