Bipolar Flashcards
What is ICD-10 definition of bipolar?
- 2 + episodes of mood disturbances (depression, mania)
- At least 1 episode has to have been mania/hypomania
What are the two DSM 5 definition for bipolar?
-Bipolar 1 – 1 episode of mania
(may be followed by episode of
depression/hypomania)
-Bipolar 2 - at least one hypomanic episode and at least one major depressive episode
Describe mania
- Symptoms must be present for at least 7 days or less if admission to hospital
- Period of abnormally & persistently elevated, expansive or irritable mood with 3+ characteristic symptoms of mania
- The disturbance must cause impairment to occupational or social function.
- Can have psychotic features
What are symptoms of bipolar?
- elevated mood
- increased energy
- increased self esteem
- psychotic symptoms
- easily distracted
- risky behaviour
- behavioural manifestations
- Disruption to work/family/social life
What are psychotic symptoms of mania?
- Grandiose delusions
- Suspiciousness – can turn into persecutory delusions
- Pressured speech so severe unable to understand
- Irritable behaviour -> violent behaviour
- Catatonic behaviour
- Complete loss of insight
Describe criteria for hypomania
-Symptoms must be present for at least 4 days
-Similar to mania symptoms
But milder
No psychotic symptoms
Functioning not markedly impaired
- If requires hospital admission -> Mania
- If only hypomania: Bipolar Type II
What is criteria for depression?
- Five (or more) of the following symptoms have been present during the same 2-week period
- at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure
- low mood
- weight loss
- insomnia
- fatigue
- loss of energy
What is definition of mixed episode
-When you have both manic/hypomanic and depressive symptoms in a single episode, present everyday for at least 1 week (DSM) or 2 weeks (ICD)
What are typical presentations of mixed episode?
- Depression + overactivity/pressured speech
- Mania + agitation and reduced energy
- Low mood + other manic symptoms
- Fluctuation between mania and depression
What is epidemiology for bipolar?
- 1.3 million people in the UK have bipolar
- prevalence is 1% to 2%
- M:F = 1:1
- Onset usually late adolescence/early adulthood but can occur at any age
- Bipolar increases an individual’s risk of suicide by up to 20 times
How likely are you to develop bipolar disorder if your first degree relative had it?
-7x more likely (5-10%)
What are chances of developing psychiatric illness if parent had bipolar?
-50%
Describe course of illness for bipolar
- Variable by person
- First episode can be hypomania, mania or depression
- Can have many years between first episode and second
- Often 5-10 year interval between onset of illness and getting help
- Manic episodes shorter than depressive if untreated (6 vs. 11 weeks)
- Rapid cycling (>4/yr)
- Gap between episodes shortens with progression
- Pregnancy (>50% chance of relapse)
What 3 social factors affect BD?
- Employment
- Social isolation
- The family
What is relationship between bipolar and employment?
-Rates of positive screening for bipolar disorder are higher in unemployed people, in those receiving particular benefits, and in people living alone.
