Bipolar Flashcards
What is the first line psychotherapy in maintenance BP tx?
Psychoeducation
What is the first line psychotherapy in acute mania?
None
What is the first line psychotherapy in acute depression?
Trick question– only second line (CBT + family based)
What is characteristic of a depressed mood that predicts bipolar? (three answers)
Rapid onset and offset of short duration (< 3mo), mixed state, loss of efficacy of AD after initial response
What is the risk of a recurrent manic episode after hospitalization?
1/2 (50%), will have a 2nd manic episode, within 2 years
which gender has a worse prognosis in bpI?
male
compare bipolar to depression heritability
60-80% vs 30-40%
mixed features bipolar responds best to?
valproic
which episode does BP most commonly start with?
MDD (75% in F, 67% in M)
which mood stabilizer is Health Canada approved for maintenance tx for BP?
valproic acid
Lesions to which side of the brain cause mania and depression?
Right- mania, left- depression
Is rapid cycling associated with hyper or hypothyroidism?
hypo
which genes are involved in BP?
chromosome 5, 11, 18, 22, X (but 18 and 22 most evidence)
Rapid cycling is more common in which type of BP
I
Which BP type spends more time in depression/
II
Higher rate of suicide during which episode of BP
mixed features
During which mood state are cognitive deficits present?
all three (mania, depression, euthymia)
safest AP to breastfeed with?
olz
which gender is more likely to rapid cycle
female
what percentage of MDD will have a manic episode in 2 yrs?
5-10%
what kind of rash does lithium cause?
psoriasis
two most common co-morbidites of BP?
- SUD 2. anxieties (OCD, PD, SAD)
How many episodes does one need to be considered for the rapid cycling specifier?
at least 4 within a 12 mo period
Does rapid cycling have a familial pattern of inheritance?
No
Criterion A for BPI/II is…
Expansive, elevated or irritable mood with increased activity/energy
Who is more likely to experience hypomanic sx? BP I or II?
I
Which type of BP has greatest genetic heritability?
BP II
Carbamazepine is best in what kind of BP
comorbid anxiety, scza with mood incongruent psychosis, neg FHx
Best tx for mixed feature episodes?
atypical AP or DVP
stroke in which hemisphere can cause mania
R
percentage of bpI who achieve remission with lithium
60%
first line tx for mania and Mdd in youth
lithium and lurasidone respectively
