Bipolar Flashcards

1
Q

Why is Bipolar II underdiagnosed

A

rare to seek help in hypomanic episode, interpret highs as recovery from depression, psychiatrists’ training lacks exposure to BPII

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2
Q

in the DSM is impairment a criterion for both BPII and BPI

A

No - only for BPI

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3
Q

what’s the duration of the manic/ hypomanic episodes in the DSM criteria

A
BPI = mania for 7 days or more
BPII = hypomania for 4 days or more
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4
Q

What is the most common BP diagnosis

A

BP NOS because patients meet symptom criteria, not duration criteria

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5
Q

how does parker discriminate between BPI and BPII

A

BPI experience psychosis in mainly manic states

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6
Q

what is the implication if BPI and BPII are treated as categorically different

A

they require different treatments not different doses of the same medication

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7
Q

which BP has higher risk of suicide

A

BPII

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8
Q

Where does SDM lie in terms of models of psychiatric care?

A

inbetween the traditional paternalistic model and the informed decision making model

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9
Q

when are DCE’s used

A

Discrete Choice Experiments used to elicit the patients preferences for the attributes of medication

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10
Q

Is BPI or BPII more of a depressive disorder

A

BPII - MDE is a major part of BPII and is not necessary for diagnosis in BPI

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11
Q

How does the DSM-5 conceptualise BPII

A

As a less severe version of BPI

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12
Q

Can you have manic episodes without psychotic features?

A

YES - contradicts Parker’s argument that psychosis differentiates BPI from BPII

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13
Q

Since Bipolar is a biological disorder, what impact does this have on depressive episodes?

A

Lows are expressed more physiologically than cognitively

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14
Q

How is illicit drug use a possible long term clue for Bipolar?

A

the person could be trying to self-medicate to stabilise mood swings

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15
Q

What are Prodromal symptoms?

A

Symptoms present immediately prior to condition manifesting,
Any part of the syndrome when the person doesn’t meet the criteria for the disorder.

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16
Q

in DSM - 5 what are the criteria for mania/ hypomania?

A

○ Abnormally and persistently elevated, expansive or irritable mood and increased goal directed activity
○ Present nearly daily

17
Q

Why do people tend not be diagnosed for Bipolar at its onset?

A

Because it typically starts with depression

18
Q

what are episodes in BP?

A

deviations from remission

19
Q

what are the 3 phases of Bipolar?

A
  1. Acute Stabilization
  2. On going maintenance
  3. Relapse Prevention
20
Q

When is Acute the Stabilization phase?

A

At the tip of the deviation from wellness (episode)

21
Q

what is monotherapy and combination therapy for depression

A
monotherapy = one medication - anti-psychotics or mood stabilizers
combination = the above with adjunctive antidepressant therapy
22
Q

when is the ongoing maintenance phase and what is the goal of treatment?

A

when in remission - to prevent future episodes

23
Q

what is prophylactic medication

A

medication taken preventitively during remission e.g. mood stabilisers

24
Q

what is Lithium used for

A

mania, depression and to prevent future episodes

25
Q

what does interpersonal and social rhythms therapy do

A

deals with changing identity/ loss of healthy self/ interpersonal skills + daily routines / sleep wake cycles

26
Q

is an MDE necessary for diagnosis of BPI?

A

no

27
Q

what is the ratio of manic : depressive episodes in BPI

A

1 : 3

28
Q

what is cyclothymic disorder?

A

chronic, less severe version of BP. Hypomanic/ depressive episodes that are not severe but still cause impairment. At least 2 years with no longer than 2 months of no symptoms.

29
Q

What is the goal of treatment in the Acute Stabilization phase of BPD?

A

to reduce arousal, agitation, aggression, behavioural disturbance, psychosis etc. Usually Pharmacotherapy. if severe - use ECT

30
Q

what is treatment emergent affective switch?

A

switching into (hypo) mania from changing dose or introducing antidepressant

31
Q

Who discovered Lithium for BPD

A

John Cade 1949. for Mania and depression