Bipolar Disorder

Question 1

Bipolar I diagnosed when…

Bipolar II diagnosed when…

Answer 1

1/ episode of mania is diagnosed
2/ episode of hypomania is diagnosed
(Ref: RACGP Bipolar Disorder 2013)

Question 2

Features that make bipolar depression than unipolar depression more likely

Answer 2

• Physical slowing (psychomotor retardation)
• Increased sleep (hypersomnia) and/or increased
appetite (hyperphagia)
• Early morning wakening/diurnal mood variation
(worse in morning)
• Delusions and hallucinations; excessive (pathological)
guilt
• Lability of mood (interspersed hypomanic symptoms)
• Early onset of first depression (<25 years)
• Multiple prior depressive episodes
• Positive family history of bipolar disorder.
(Ref: RACGP Bipolar Disorder 2013)

Question 3

Medication to prevent recurrences

Medications that prevent recurrence of depressive episodes

Answer 3

Lithium
Quetiapine / Olanzapine
(Ref: RACGP Bipolar Disorder 2013)

Question 4

Adverse effects of lithium.

Answer 4

Increased risk of

• Hypothyroidsim
• Hyperparathyroidism
• weight gain

(Ref: RACGP Bipolar Disorder 2013)

Question 5

Symptoms of mania and hypomania (sx need to be present for 4/7 for hypomania and 7/7 for mania)

Answer 5

1/ Elevated Mood
2/ Increase energy
3/ Reduced need for sleep
4/ Grandiose delusions
5/ Disinhibited behaviour e.g. inc sexual drive, inc spending
6/ Pressured / Loud speech
7/ Distractible e.g. dec ability to foucs
8/ Enhanced perception experiences e.g. colours richer than normal

(Ref: RACGP Bipolar Disorder 2013)