Bipolar Flashcards
Why is Bipolar II underdiagnosed
rare to seek help in hypomanic episode, interpret highs as recovery from depression, psychiatrists’ training lacks exposure to BPII
in the DSM is impairment a criterion for both BPII and BPI
No - only for BPI
what’s the duration of the manic/ hypomanic episodes in the DSM criteria
BPI = mania for 7 days or more BPII = hypomania for 4 days or more
What is the most common BP diagnosis
BP NOS because patients meet symptom criteria, not duration criteria
how does parker discriminate between BPI and BPII
BPI experience psychosis in mainly manic states
what is the implication if BPI and BPII are treated as categorically different
they require different treatments not different doses of the same medication
which BP has higher risk of suicide
BPII
Where does SDM lie in terms of models of psychiatric care?
inbetween the traditional paternalistic model and the informed decision making model
when are DCE’s used
Discrete Choice Experiments used to elicit the patients preferences for the attributes of medication
Is BPI or BPII more of a depressive disorder
BPII - MDE is a major part of BPII and is not necessary for diagnosis in BPI
How does the DSM-5 conceptualise BPII
As a less severe version of BPI
Can you have manic episodes without psychotic features?
YES - contradicts Parker’s argument that psychosis differentiates BPI from BPII
Since Bipolar is a biological disorder, what impact does this have on depressive episodes?
Lows are expressed more physiologically than cognitively
How is illicit drug use a possible long term clue for Bipolar?
the person could be trying to self-medicate to stabilise mood swings
What are Prodromal symptoms?
Symptoms present immediately prior to condition manifesting,
Any part of the syndrome when the person doesn’t meet the criteria for the disorder.
in DSM - 5 what are the criteria for mania/ hypomania?
○ Abnormally and persistently elevated, expansive or irritable mood and increased goal directed activity
○ Present nearly daily
Why do people tend not be diagnosed for Bipolar at its onset?
Because it typically starts with depression
what are episodes in BP?
deviations from remission
what are the 3 phases of Bipolar?
- Acute Stabilization
- On going maintenance
- Relapse Prevention
When is Acute the Stabilization phase?
At the tip of the deviation from wellness (episode)
what is monotherapy and combination therapy for depression
monotherapy = one medication - anti-psychotics or mood stabilizers combination = the above with adjunctive antidepressant therapy
when is the ongoing maintenance phase and what is the goal of treatment?
when in remission - to prevent future episodes
what is prophylactic medication
medication taken preventitively during remission e.g. mood stabilisers
what is Lithium used for
mania, depression and to prevent future episodes
