Bipolar and Depressive Disorders

Question 1

manic episode characteristics

Answer 1

• abnormally and persistently elevated, expansive, or irritable mood
• increased activity or energy for at least one week
• three or more characteristic symptoms (e.g., inflated self-esteem or grandiosity, decreased need for sleep, flight of ideas)
• marked impairment in functioning
• a need for hospitalization to avoid harm
• the presence of psychotic features

Question 2

hypomanic episode characteristics

Answer 2

• an abnormally and persistently elevated, expansive, or irritable mood
• increased activity or energy
• three or more symptoms of mania
• at least four consecutive days
• Symptoms are not severe enough to cause impairment or hospitalization
• does not include psychotic features.

Question 3

major depressive episode characteristics

Answer 3

• five or more characteristic symptoms
• at least one symptom is depressed mood or loss of interest/pleasure in activities
• Symptoms last at least two weeks
• cause significant distress and/or impaired functioning

Question 4

diagnoses in the Bipolar disorders category

Answer 4

bipolar I
bipolar II
cyclothymic disorder

Question 5

bipolar I diagnosis

Answer 5

• at least one manic episode

* may or may not have been preceded or followed by one or more major depressive or hypomanic episodes

Question 6

bipolar II diagnosis

Answer 6

• at least one hypomanic episode

* at least one major depressive episode

Question 7

cyclothymic disorder diagnosis

Answer 7

• numerous periods of hypomanic symptoms that do not meet the criteria for a hypomanic episode
• numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode
• minimum duration of symptoms is two years for adults, one year for children/adolescents

Question 8

etiology of bipolar disorder

Answer 8

Bipolar disorder has been linked to heredity, neurotransmitter and brain abnormalities, and circadian rhythm irregularities

Question 9

bipolar disorder twin study concordance rates

Answer 9

monozygotic: .67 to 1.0
dizygotic: about .20

Question 10

neurotransmitters affecting bipolar disorder

Answer 10

norepinephrine, serotonin, dopamine, and glutamate

Question 11

areas of structural and functional abnormalities linked to bipolar disorder

Answer 11

prefrontal cortex, amygdala, hippocampus, and basal ganglia

Question 12

circadian rhythm irregularities linked to bipolar disorder

Answer 12

sleep-wake cycle, the secretion of hormones, appetite, and core body temperature

Question 13

Evidence-based psychosocial interventions for bipolar disorder

Answer 13

• family focused therapy
• psychoeducation
• interpersonal and social rhythm therapy
• cognitive-behavior therapy

Question 14

pharmacotherapy treatments for bipolar disorder

Answer 14

• lithium for classic bipolar presentation

* anticonvulsant and second generation antipsychotic drugs for atypical bipolar disorder

Question 15

“classic” bipolar presentation (not DSM 5)

Answer 15

• separation of manic/hypomanic and depressive episodes by long periods of recovery
• low likelihood of mixed mood states and rapid cycling
• onset between 15 and 19 years of age

Question 16

“atypical” bipolar disorder presentation (not DSM 5)

Answer 16

• mixed mood states
• rapid cycling
• a lack of full recovery between episodes
• onset between 10 and 15 years of age

Question 17

DSM 5 bipolar disorder with atypical features specifier criteria

Answer 17

• mood reactivity
• at least two of the following:
• significant weight gain or increase in appetite
• hypersomnia
• leaden paralysis
• interpersonal rejection sensitivity