Bipolar disorder

Question 1

Mania

Answer 1

-5-10% mood disorders in elderly

Question 2

1 year prevalence in over 65s

Answer 2

-0.4%
-younger adults is 1.4%
-average age is 55 years
F:M 2:1

Question 3

Diagnosis of mania

Answer 3

• at least one week of elated mood, overactivity and self-important ideas
• in severe cases grandiose delusions and hallucinations may be seen
• insight is absent

Question 4

Relationship with comorbid neurology

Answer 4

-patients with first episode of mania in later life are twice as likely to have a comorbid neurological disorder

Question 5

Secondary mania

Answer 5

• manic illness that starts without prior history of affective disorder in close temporal relationship to a physical illness or drug treatment
• stroke, head injury, HIV, steroids and anti PD drugs

Question 6

Lithium

Answer 6

• first line prophylaxis

- 0.4-0.6 mmol/L is suggested as prophylaxis

Question 7

Antipsychotics

Answer 7

• used in acute mania

- often at low dose