Bipolar concepts

Question 1

who is the ‘father of classification?’

Answer 1

Emil Kraeplin

kept records of inpatients for several years

Question 2

The great “Kraeplinian dichotomy”

Answer 2

“Schizophrenia”

1. in young-> chronic: dementia precox (Bleuler called it schizophrenia)
2. in older-> episodic, good course: manic-depression

Question 3

Karl Jaspers

Answer 3

1883-1969
Difference between mania and depression, and distinquishing from schizophrenia
Psychosis in SCZ “un-understandable”- phenomenology

Question 4

Karl Jaspers

Answer 4

1883-1969
Difference between mania and depression, and distinguishing from schizophrenia
In mania/depression- understandable
Psychosis in SCZ “un-understandable”- phenomenology

Question 5

Kurt Schneider

Answer 5

Pathagnomoic sx of SCZ
First rank symptoms
Delusion of percept

Question 6

John Cade

Answer 6

1912-1980

Discovered lithium

Question 7

Classification before DSM3

Answer 7

Organic
scz
paranoid psychoses
affective psychoses
neuroses

Question 8

current conceptual heirachy

Answer 8

Organic
SCZ
Delusional
BP
Unipolar
Recurrent non-mel depression
OCD
"Neuroses"
-dysthymia
-anxiety states

Question 9

Bipolar “spectrum”

Answer 9

BP1- manic/depression
BP2- occasional hypomania, predominant melancholia
BP3- hypomania on AD/ECT
Unipolar?- undeclared
Cyclothymia- episodes of hypomania without depressive episodes

Question 10

Bipolar psychoses

Answer 10

Psychotic sx confined to affective episodes

No FRS, content understandable

Question 11

T1 vs T2 SCA

Answer 11

1: psychotic sx confined to affective (more likely to become BP)
-FRS present, content understandable
2: Psychoses confined to affective (more likely to become SCZ)
-FRS present, content understandable
Schizo-manic
Schizo-depressive

Question 12

First rank sx

Answer 12

1. DELUSIONAL PERCEPTION
   Part of a Primary delusion. It can occur ‘out of the blue’ (Autochthonous delusion) or as a two stage process where a normal perception occurs first and then a delusion if formed around it. (Delusional perception)
   e.g. ‘When I saw the red car passing by me yesterday, I knew I was going to be killed.’
2. AUDITORY HALLUCINATIONS
   Third-person auditory hallucinations (arguing or talking about patient) – ‘He or she’
   Running commentary on person’s actions or thoughts
   Thought echo (Gedankenlautwerden) – Thoughts spoken aloud
3. DELUSIONS OF THOUGHT INTERFERENCE
   Thought insertion (put into your head)
   Thought withdrawal (taken out of your head)
   Thought broadcasting (broadcast so that other people know what you are thinking)
4. PASSIVITY PHENOMENON OR DELUSIONS OF CONTROL
   Control of the following by an external force:
   Impulses
   Actions
   Feelings
   Somatic Passivity – Passive recipient of bodily sensations imposed from outside forces.

Question 13

Presentations psychotic depression

Answer 13

Melancholic
Atypical
-agitation, PCD, delusional predominance is
-poverty/catastrophy, contamination, guilt, infestation, illness/syphillis/HIV
-hypochondriasis, nihilistic, stupor, catatonia, pseudo-delirium, pseudo-dementia