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PSYC3018 > Bipolar > Flashcards

Bipolar Flashcards

1
Q

The initial stages of a manic episode are…

But then, as the thinking wheel gets faster…

A

a lot of fun - your self-esteem goes up, you feel important and confident (heightened wellbeing)
you get to the stage of euphoria and mania - ideas start coming quickly - people become agitated and irritable

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2
Q

Often in a manic episode, you will fluctuate between…

A

elation and irritability

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3
Q

Manic episode must last at least

A

one week

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4
Q

The new sub-criterion within Criterion A of Bipolar I states that the individual…

A

has increased goal-directed activity/energy, present nearly daily

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5
Q

During a manic episode, the individual can function very well on _______

A

~ 2 hours sleep

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6
Q

Manic patient is often involved in _______ behaviours

A

high-risk, dangerous

eg gambling, promiscuity

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7
Q

After a manic episode, the individual often feels

A

guilt/regret as to the damage they caused to their career, family etc

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8
Q

Criterion C of Bipolar I states that the mood disturbance is:

A
  • sufficiently severe to cause marked impairment in occupational functioning or in usual social activities
  • OR to necessitate hospitalisation to prevent harm to self/others
  • OR there are psychotic features (hallucinations/delusions)
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9
Q

up to ____ of people with Bipolar I will attempt suicide

A

half

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10
Q

A hypomanic episode lasts at least ___ days

A

4

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11
Q

What is the difference between a hypomanic episode and a manic episode?

A

symptoms are the same.
Difference is in Criterion C
- While the disturbance & changes are observable to others, they are not sufficiently severe to cause marked impairment in occupational functioning/necessitate hospitalisation/no psychotic features
- highs are not as high (can still function)

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12
Q

Is a major depressive episode necessary for Bipolar I/II?

A

No for Bipolar I

Yes for Bipolar II

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13
Q

For Bipolar II, you need to have had

A

at least one MD episode and one hypomanic episode. No manic episodes.

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14
Q

Cyclothymic disorder is characterised by

A

numerous cycles of hypomanic symptoms and depressive symptoms that are not severe enough to meet criteria for manic or MD episode

= the chronic, less severe form of Bipolar

constantly oscillating

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15
Q

Duration of cyclothymic disorder?

A

Symptoms for at least 2 years, no more than 2 months without symptoms

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16
Q

why is dangerous to misdiagnose Bipolar as Unipolar Depression?

A

Antidepressants can trigger mania

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17
Q

Are there gender differences in bipolar?

A

no, except that rapid cycling seems to be affecting women more

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18
Q

often people with Bipolar will not receive treatment/be diagnosed correctly until

A

10-20 years after onset

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19
Q

Even when treated, ____ will relapse within 1-year, ___ within 5 years

A

40%, 73%

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20
Q

The course of bipolar is predominantly ________

A

depressive (Bipolar II more so than Bipolar I)

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21
Q

Bipolar patients do spend a significant portion of their lives feeling normal/well. This is called

A

euthymia

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22
Q

rapid cycling is …

A

4+ episodes a year - affects 5-15% of sufferers

23
Q

Bipolar is often comorbid with..

A 
Anxiety disorders (50%)
Substance abuse (39%)
24
Q

What are the 3 aetiological factors of Bipolar?

A
  1. Genetic/biological factors
  2. Environmental and Life stressors
  3. Psychological factors
25
Q

If one parent has Bipolar the chance of their child developing it is ___. If both parents have bipolar the chance goes up to ____.

A

10%, 40%

26
Q

Bipolar is a neurobiological disorder, largely due to the malfunction of three neurotransmitters:

A

serotonin, dopamine and noradrenaline

27
Q

These biological vulnerabilities to bipolar may lay ______. Can be activated ________ or triggered by environmental/life ________.

A

dormant
spontaneously
stressors

28
Q

Manic episodes are likely preceded by…

A
  • disruption to routines and sleep-wake cycles

- excessive focus on goal attainment (over-invested in one thing)

29
Q

Depressive episodes are likely preceded by…

A
  • low social support

- low self-esteem

30
Q

What are the psychological factors that contribute to Bipolar?

A
  • negative cognitive style (esp. when paired with stressful events)
  • mania = overcompensation for low self-esteem - cognitions go in opposite direction
31
Q

Which personality traits are implicated in bipolar?

A
  • perfectionism

- sociotropy = over-investment in social relationships, don’t take rejection well

32
Q

According to the Diathesis-Stress model, what is the order of events to elicit Bipolar?

A

Life stressors causing poor social routines and/or sleep deprivation
—–> and you have biological vulnerability i.e. Circadian rhythm instability
—–> prodromal stage (early symptoms of mood disturbance)
——–>if you use poor coping strategies to deal with these early symptoms——->
Full-blown episode
which can lead back to causing stress

vicious cycle

33
Q

Best treatment outcomes are achieved when…

A

We combine pharmacological treatment with (adjunct) psychological intervention. But pharmacological treatment will always be the primary treatment

34
Q

Treatment needs to be tailored to the patient - depends on…

A 
Illness stage (acute, maintenance)
Predominant polarity (depressive, hypo/manic)
35
Q

____ of patients relapse within ____ months of ceasing lithium

A

50%, 5

36
Q

Anticonvulsants are used for people who..

A

have rapid cycling, increased levels of irritability

37
Q

Sedative hypnotics (benzos) are given to help with

A

sleep

38
Q

How are antidepressants administered to Bipolar patients?

A

Lower doses, shorter duration

- combined with mood stabilisers so they’re not at risk of inducing mania

39
Q

____ is used when medication is not viable

A

ECT

40
Q

What are the two main types of psychotherapy for Bipolar?

A

CBT and psycho-education

- equally effective

41
Q

Atypical antipsychotics such as Olanzapine are used to counter the

A

psychotic features that may be present during a manic episode

42
Q

Psycho-education is most commonly conducted…

A

in a group setting

43
Q

Psycho-education provides info on…

A
  • symptoms of BP
  • strategies to cope with stressors
  • need for routines —> minimise disruption of sleep-wake cycles
  • identifying early signs of relapse
  • diathesis-stress model of BP
  • the rationale/importance of medication compliance
44
Q

Psycho-education effects?

A
  1. delays recurrence

2. reduces frequency of future episodes

45
Q

The key technique in CBT is ___. CBT is effective in…

A

cognitive restructuring - challenging and changing unhelpful thinking

reducing episodes and hospitalisations, improving medical compliance

46
Q

Recent studies show benefits of …

A

MBCT in assisting the patient to manage both anxiety and depressive symptoms primarily between episodes

47
Q

Male patients with bipolar are often misdiagnosed as having ____________, female patients with bipolar are often misdiagnosed as having ______________.

A

schizophrenia

unipolar depression

48
Q

Lithium fully protects only ________ percent of patients against further episodes

A

25-50

49
Q

What is the Goal Dysregulation Model?

A

Mania is the result of excessive goal engagement. Even when not in an episode, individuals with a history of bipolar I disorder have been found to place a higher emphasis on rewards and to be excessively engaged int he pursuit of achieving goals compared to those without the disorder

50
Q

Johnson et al. (2000) found that specifically ____________ life events, and not __________ life events, were associated with elevations in subsequent manic symptoms. In contrast, ___________

A

goal-directed
general positive
goal attainment was not associated with changes in depression

51
Q

Studies have found that symptom severity in bipolar is significantly associated with ….

A

sociotropy, negative interpersonal events and the interaction of the two

52
Q

Why is mood monitoring an important intervention in the early stages of therapy?

A

Encouraging clients to keep structured mood diaries helps in identifying the triggers to mood shifts and the associated changes in thoughts and feelings

53
Q

What is Interpersonal and Social Rhythm Therapy?

A

aims to reduce disruptions in daily routines and sleep/wake cycles that trigger bipolar episodes

  • regulate social rhythms
  • address interpersonal difficulties
54
Q

The instability model of bipolar disorder relapse assumes four key mechanisms that trigger relapse in bipolar disorder. What are they?

A
  1. biological vulnerability
  2. medication non-adherence
  3. disrupted routines
  4. dysfunctional interpretations of life events

2,3 and 4 —-> sleep disturbance mania/depression

PSYC3018 (15 decks)

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