Bipolar Affective Disorder Flashcards
ICD classification of bipolar
hypomania
mania with psychotic features
mania without psychotic features
onset of bipolar
late teens/ early 20s
FH often results earlier
what is BAD defined as?
two or more episodes where the patient’s mood/ activity are significantly disturbed, consisting of hypomania or mania and depression
presentation of hypomania
mood elevated to concerning degree and sustained for at least 4 days with at least 3 of:
- increased activity/ restless
- increased talkativeness
- difficulty concentrating
- decreased need for sleep
- increased sexual energy
- mild spending sprees or other types of reckless behaviour
presentation of mania
mood elevation sustained for at least 1 week (or severe enough to require hospital admission)
- hypomania symptoms
- flight of ideas or experience of thoughts racing
- loss of social inhibitors/ inappropriate behaviour
- grandiosity
diagnosis of BAD
MSE
psychotic symptoms= delusions/ hallucinations
co-morbdities
MSE associations with bipolar/ mania
bright clothes distractibility overfamiliarity increased talkativeness punning and clang associations increased thought flow flight of ideas loosening of associations grandiosity
bipolar I
mania + depression
bipolar II
hypomania + depression
co-morbidities in bipolar
anxiety substance misuse personality disorder eating disorder schizophrenia
maintenance management options for BAD
- lithium
2. ECT
acute mood stabilisers in BAD
anticonvulsants
antipsychotics (FIRST LINE)
BZDs
antidepressants
what is lithium
an element so is not subject to metabolism and excreted by the kidneys
indistinguishable from Na+ so risks dehydration
normal side effects of lithium
strange taste polydipsia polyuria tremor hypothyroid reduced renal function nephrogenic DI weight gain
toxic side effects of lithium
D&V coarse tremor altered consciousness drowsy convulsions coma
