Bipolar Disorder

Question 1

What is the prevalence of bipolar disorder?

Answer 1

1%

Question 2

What are some risk factors for bipolar disorder?

Answer 2

Genetic
Head injury
Organic CNS disease
AIDS

Question 3

What are symptoms of mania?

Answer 3

Elevated mood
Irritable mood
Increased self esteem
Subjective decreased need for sleep
Increase talkativeness
Flight of ideas 
Distractibility
Increase social activities
Risk taking behaviour
Increase sexual activities

Question 4

What is Bipolar I?

Answer 4

Mania +/- depressive episodes

Question 5

What is Bipolar II?

Answer 5

Hypo-manic episodes + depressive episodes

Question 6

What is Bipolar III?

Answer 6

Depressed patients who develop hypomania during treatemnt for depression

Question 7

What is bipolar IV?

Answer 7

Depressed patients with substance-induced hypomania

Question 8

What is cyclothymia?

Answer 8

Dysphoric (mild depressive episodes) episodes alternating with hypo-mania

Question 9

What is hypo-mania?

Answer 9

Increased well being and/or irritable mood, busy, pressured speech, more telephone calls, seductive
- More tolerable to a normal life

Question 10

What is the diagnostics differences between mania and hypomania?

Answer 10

Mania >1 week to diagnose
Hypomania 4 days

Mania has disruption to social, occupational status whereas hypomania doesn’t

Question 11

What is the clinical pattern of bipolar?

Answer 11

Usually presents as depression, mania ~5 years on
Usually begins in adolescence - brief, mild, uncharacteristic
20-30% cases are biphasic
Median duration of mania is 4.2/12

Question 12

What are the differential diagnoses for bipolar?

Answer 12

Schizophrenia
Primary organic state
Drug induced psychosis 
Euthymia in depressives 
Creative - possess by the muse
Extroverted, cyclothymic, borderline or histrionic personality

Question 13

What are treatments for bipolar?

Answer 13

Mood stabilizers - lithium most effective
Second generation anti-psychotics 
Antidepressant
ECT
Anti-convulsants

Question 14

What are the symptom requirements to meet criteria B) of a manic episode in DSMV?

Answer 14

Must have 3 (or 4 if irritable) out of the following 7

FIDGETS

F - Flight of ideas or subjective experience of racing thoughts
I - Insomnia, decreased subjective requirement for sleep
D - Distractibility
G - Grandiosity
E - Engaging in risky behaviour - spending, gambling, sex
T - Talkative - more talkative
S - Super busy - increased goal directed behaviour or psychomotor agitation

Question 15

What are the DSMV criteria for bipolar I disorder?

Answer 15

A) A period of one week or more of abnormally elated, irritable, or expansive mood and increased goal directed behaviour
B) During this period three (or four if mood is only irritable) out of the following seven must be present
i. Flight of ideas or subjective experience of racing thoughts
ii. Insomnia, decreased subjective requirement for sleep
iii. Distractibility
iv. Grandiosity
v. Engaging in risky behaviour - spending, gambling, sex
vi. Talkative - more talkative
vii. Super busy - increased goal directed behaviour or psychomotor agitation
C) Symptoms cause social or occupational dysfunction or require hospitalisation
D) Symptoms cannot be attributed to the affect of other substance or medical condition

May also have episodes of hypomania or major depression but not required for diagnosis of bipolar I