Bipolar Disorder

Question 1

What is bipolar

Answer 1

Episodes of mania alongside depression

Question 2

Epidemiology of bipolar

Answer 2

Lifetime prevalence – 0.7-1.6/100,000

M=F

Mean age – 21

Question 3

Risk factors for bipolar

Answer 3

First degree relatives (10x)

Other disorders

• depression
• substance misuse
• personality disorder
• ADHD

Can be triggered e.g. drugs

Question 4

Types of bipolar

Answer 4

Bipolar I – at least 1 manic episode last >1 week, usually coupled with episodes of depression (not always recorded)

Bipolar II - >1 episode of severe depression but only coupled with hypomania

Rapid cycling - >4 mood swings in 1 year

Cyclothymia – mood swings not as severe as bipolar (mild highs, mild lows)

Question 5

Criteria for bipolar

Answer 5

Repeated (2+) episodes of depression and mania/hypomania

If no mania – depression

If no depression – hypomania or bipolar

Question 6

Treatment of bipolar

Answer 6

Mood stabiliser

• lithium

Antidepressant (must stop when manic)

Antipsychotics

Anticonvulsants

Benzodiazepines

CBT (not helpful during mania)

Question 7

Prognosis of bipolar

Answer 7

Lasts 1-2 months

• 60% recovered at 10 weeks

5% fail to recover

90% have further episodes

10% die by suicide