Bipolar Flashcards
What defines bipolar disorder according to the DSM-5?
The experience of a manic or hypomanic episode
Mania is considered the affective opposite of depression.
What characterizes a manic episode?
At least 1 week of an abnormal and persistently elevated, expansive, or irritable mood, accompanied by increased goal-directed activity.
What are three symptoms required for a manic episode diagnosis?
Symptoms include:
* Inflated self-esteem or grandiosity
* Decreased need for sleep
* Pressured speech
* Flight of ideas
* Distractibility or increased hyperactivity
* Involvement in high-risk activities
How long must a hypomanic episode last?
4 days or longer, not severe enough to warrant hospitalization.
What are the two types of bipolar disorder in the DSM-5?
Bipolar I and Bipolar II.
What characterizes Bipolar I disorder?
Chronic disorder marked by one or more manic or mixed episodes.
What distinguishes Bipolar II disorder?
One or more major depressive episodes accompanied by at least one hypomanic episode.
True or False: Bipolar disorder type II is often misdiagnosed as major depression.
True.
What is the gold standard for treating type I bipolar disorder?
Lithium.
What is a pre-lithium workup?
Includes:
* Complete blood cell count
* ECG
* Urinalysis
* Electrolytes
* Thyroid function tests
* Renal function tests
What are symptoms of lithium toxicity?
Symptoms include:
* Lethargy
* Coarse tremor
* Confusion
* Seizures
* Coma
What is the treatment of choice for severe lithium toxicity?
Hemodialysis.
What are some mood stabilizers besides lithium?
Includes:
* Divalproex/valproic acid
* Carbamazepine
* Lamotrigine
What is a side effect of Divalproex?
Hepatotoxicity.
What is the role of antipsychotics in treating bipolar disorder?
Used to treat acute symptoms of mania and can have mood-stabilizing properties.
Which antidepressant combination is approved for treating depression in type I bipolar disorder?
Fluoxetine in combination with olanzapine.
What is the primary characteristic of Generalized Anxiety Disorder (GAD)?
Excessive worry or anxiety for 6 months or more.
What characterizes panic disorder?
Discrete periods of sudden, intense fear or terror.
What is agoraphobia?
Intense fear in two or more settings, often in public or open spaces.
What distinguishes social anxiety disorder?
Marked and persistent fear in social or performance situations.
What defines obsessive-compulsive disorder (OCD)?
Obsessions are intrusive thoughts; compulsions are ritualistic behaviors.
What is a key treatment for PTSD?
Psychotherapy is considered the cornerstone of treatment.
What are first-line medications for GAD?
SSRIs (escitalopram, paroxetine, sertraline) and SNRIs (duloxetine, venlafaxine XR).
What is the role of benzodiazepines in anxiety treatment?
Rapidly effective for agitation, but not recommended for long-term use.
What is the first-line treatment for panic disorder?
Antidepressants, including all SSRIs and venlafaxine.
What is the treatment of choice for mild OCD in adolescents and adults?
Cognitive Behavioral Therapy (CBT).
What is the most important treatment modality for social anxiety disorder?
Cognitive Behavioral Therapy (CBT).
What is the treatment approach for specific phobias?
Not typically treated with medication; behavioral approaches are effective.
