Bipolar Affective Disorder

Question 1

Bipolar affective disorder

Answer 1

• chronic psychiatric condition
• characterised by severe mood swings
• range from depressive lows to manic highs

Question 2

Classifying bipolar disorder

Answer 2

Type 1:
- mania and depression
- most common

Type 2:
- hypomania and depression

Question 3

Clinical features of bipolar disorder

Answer 3

Mania:
- severe functional impairment or psychotic symptoms
- for 7 days or more

Hypomania:
- decreased or increased function (without psychosis)
- for 4 days or more

Question 4

Differentials for bipolar disorder

Answer 4

• major depressive disorder
• borderline personality disorder
• schizophrenia

Question 5

Pharmacological management of bipolar disorder

Answer 5

First line: Mood stabiliser or antipsychotic
1. lithium (risperidone, sodium valproate, quitiepine)
2. remove exacerbating factors
3. reduce agitation - olanzapine (lorazepam)

Second line: Alternative first-line drug or comination therapy

Third line: Electroconvuslive therapy

Fourth line: Deep brain stimulation

Question 6

Management options in bipolar disorder

Answer 6

1. CBT, family focused therapy
2. pharmacology
3. social support