Bipolar Disorder Flashcards
What is Bipolar Disorder?
It is characterized by a manic or hypomanic episode plus a major depressive episode.
Who is considered to have published the first documented diagnosis of Bipolar Disorder?
Jean-Pierre Falret published an article describing what he called “la folie circulaire” translating into “circuklar insanity” where he details people switching through severe depression and manic excitement
Who coined the term manic depressive psychosis?
Emil Kraeplin, in earlier editions of the DSM, BPD was referred to as “Manic Depression” but is now called Bipolar Disorder in the DSM:5
What are the diagnostic features of Bipolar I?
It is a manic episode characterized by:
- a distinct period of abnormally elevated, expansive, or irritable mood, abnormally and persistently increase goal-directed activity or energy lasting at least 1 week and present most of the day, nearly every day
-Three or more of the following:
-Inflated self esteems
-Decreased need for sleep
- Flight of ideas/racing thoughts
-Distractibility
- Increase in goal directed activity
- Excessive involvement in activities that have high potential for painful consequences
-Causes marked impairment in social/occupational functioning
And a major depressive episode following the manic episode
What are the diagnostic features of Bipolar II?
A hypomanic episode characterized by:
- Distinct period of abnormally elevated, expansive, or irritable mood; abnormally and persistently increases goal-directed activity or energy lasting at least 4 consecutive days and present most of day, nearly everyday
-Three or more of same criteria as BPI
- Episode is associated with an unequivocal change in functioning
- Disturbance in mood and change in functioning is observable by others
- The episode is not severe enough to impair social/occupational functioning or result in hospitalization
Followed by a major depressive episode (must last at least 2 weeks)
What is the prevalence of bipolar I and bipolar II? And what is the onset age of both?
12 month prevalence estimate is approximately 0.6 % for bipolar I and 0.3% for bipolar II.
Bipolar I: mean age of onset is 18
Bipolar II: average age of onset is mid 20s
What is rapid cycling?
It is when you have 4 or more mood cycles per year
What is lability?
Rapid shifts in mood
What is genome-wide association study?
Phenotype-first approach
What gene us associated with risk of BPD?
The gene is SYNE1, which encodes nesprin-1
What must any major neurobiological theory of bipolar disorder explain?
Every major neurobiological theory of BPD must explain the cyclical nature of the disease
What was the drug to successfully treat BPD?
Lithium was first drug to treat BPD, it was classified as a mood stabilizer. It can also be treated with valporic acid
What are the neurobiological theories of Bipolar Disorder?
- Dopamine Theory
- BDNF
- Mitochondrial theory
What is the Dopamine Theory of BPD?
-Mania can be provoked in individuals who consume moderate to high doses of amphetamines (which primarily work to elevate synaptic levels of dopamine)
-Traditional drugs used to treat BPD do have some action on D2/3 receptors
-A failure of dopamine receptor and transporter homeostasis might underlie the pathophysiology of BPD
What is a Mitochondria?
Organelles responsible for multiple cellular functions, also sources for cellular growth, cell resilience and death pathways
