Bipolar and Related Disorders Flashcards
Bipolar is placed between ______ & _______ as a ______ in terms of symptomology, family history, and genetics.
- SZ
- depressive disorders
- bridge
Kay Redfield Jamison states that people with bipolar disease can be _____ ________.
high functioning
BD patients will experience shame after an episode because of what?
they gain insight on what they did during an episode
BD patients experiencing mania will want to ______ the episode? How do they do this?
extend; with substance use
ex: cocaine
When is it best to work with a BD1 patient?
When they are at baseline/euthymia
What can precede or follow a manic episode?
hypomania or major depressive episode
What is criteria A for BD1?
for one week one must experience elevated, expansive, or irritable mood
they are persistently goal-directed full of energy
What is needed for criteria B in BD1?
think # of sxs
must have 3 or more symptoms
*4 or more if the mood is irritable
What are the 7 symptoms of BD1?
- inflated self-esteem; tangible grandiosity
- less need for sleep
- more talkative than usual or have a pressure to keep talking
- racing ideas/thoughts
- easily distracted by unimportant stimuli
- increase in goal-directed activity
- excessive involvement in activity that may have really bad consequences
T/F people are commonly arrested during BD1?
True
What is needed for criteria C?
the mood disturbance must be severe enough to caused MARKED IMPAIRMENT in social or occupational functioning
OR
there is a need to be hospitalized to prevent harm to self or to others
OR there are psychotic features
What automatically qualifies as a manic episode over the duration of the 1 week requirement of sxs?
being hospitalized
What is different in the hypomanic criteria from manic criteria?
A. duration 4 days
B. No differences
C. there is a change from prior functioning but it is not markedly impairment
D. mood and change is observable by others
E. no marked impairment, no hospitalization, no psychotic features
What is criteria A for BD2?
think duration
must have a hypomanic episode for 4 or more days & and current or past major depressive episode of 2 weeks or longer
What is great chronicity?
Which BD spends less time in euthymia?
GC = less time at baseline & episodes last longer
BD2
What are BD2’s distinct episode features?
think duration phase & impulsivity
longer depressive phases
common impulsivity = suicide attempts & substance use
What is criteria A for cyclothymia?
think duration sxs
must experience hypomania & depressive symptoms for at least 2 years for adults/1 year for youth
What is criteria B for cyclothymia?
duration requirements
during the 2 yr period at least 1/2 the time must experience the symptoms and remissions periods cannot be longer than 2 months
What is criteria C for cyclothymia?
never had an episode of M or D
Name 2 BD related disorders and their causes.
- Substance/Medication-Induced Bipolar and Related Disorder
-intoxication/withdrawl
-steroids
-cocaine
-methamphetamine
-amphetamine - Bipolar and Related Disorder Due to Another Medical Condition
-TBI
-stroke
-tumor
-multiple sclerosis
-Cushing’s disease
What is the duration prevalence of cycling?
35% go through 1 cycle in 5 years
1% go through 1 cycle every 3 months
What is rapid cycling?
experiencing 4 cycles (episodes) in 1 year
episodes have a max of 2 month remissions or they switch to opposite polarity
___% of BD patients abuse ____.
50%; illicit substances
What is the indirect and direct pathway that light regulates people?
- indirect: modulates circadian rhythms
- direct: can affect mood without disrupting circadian rhythms
What is the epidemiology for BD1, BD2, & cyclothymia?
BD1: equal between genders; onset at 18
BD2: higher in males; onset at mid 20s
Cycl.: equal between genders; onset at adolescence/early adulthood
What is the gender difference in epidemiology?
females experience mixed episodes, more depressive symptoms, and more comorbidity of alcohol use
BD carries a lifetime ___ times higher risk of suicide in comparison to the general population.
15
BD accounts for ___% of all completed suicides.
25
What are the commonalities and differences of BD & BPD?
impulsivity and mood liability
BPD doesn’t had overlapping neurological pathways
stronger genetic contributions in BD
sexual abuse and parasuicidal behaviors are more comorbid with BPD
What is borderline personality disorder?
a pervasive pattern of instability of interpersonal relationships, self-image, and markedly impulsivity
