Bipolar Disorder Flashcards

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1
Q

how does ICD 10 describe bipolar disorders

A

based on severity:

  • hypomania
  • mania with psychotic features
  • mania without psychotic features
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2
Q

how does DSM V describe bipolar disorders

A

based on course and pattern

  • Bipolar I and II
  • cyclothymic disorder
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3
Q

what is bipolar affective disorder (ICD-10)

A

disorder characterised by 2 or more occasions the patients mood and activity levels are significantly disturbed, on some occasions this consists of hypomania/mania and on others depression

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4
Q

a single episode of hypomania/mania in the absence of a history of depression is why

A

bipolar disorder - even if no history of depression

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5
Q

the first episode of hypomania/mania on a background of depression makes it what

A

bipolar disorder

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6
Q

hypomanic episode lasts for at least ____

A

4 days

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7
Q

manic episode lasts for at least ____

A

1 week

or hospitalised

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8
Q

what is hypomania

A

mood that is elated and irritable to a degree that is definitely abnormal for that individual and sustained for at least 4 days consecutively

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9
Q

what is mania

A

mood that is elated, expansive and irritable to a degree that is definitely abnormal for that individual. The mood change is prominent and sustained for at least a week or severe enough for hospital

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10
Q

what is the criteria for hypomania (6)

A

3 of the following symptoms present for at least 4 days and some interference with personal functioning in daily living:

  • increased activity and physical restlessness
  • decreased need for sleep
  • increased talkativeness, sociability and over friendliness
  • increased sexual energy
  • difficulty concentrating / distractability
  • irresponsible / reckless behaviour e.g. mild spending sprees etc
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11
Q

what is the criteria for mania (9)

A

3 of the following symptoms present for at least a week and leading to severe interference of personal functioning in daily living:

  • increased activity and physical restlessness
  • decreased need for sleep
  • increased talkativeness
  • flight of ideas
  • loss of social inhibitions –> inappropriate dress or behaviour
  • marked increase in sexual energy or sexual indiscretion
  • distractability
  • grandiosity or increased self esteem
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12
Q

what is the average age of onset of bipolar disorder

A

21 (late teens - early 20s)

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13
Q

what genes are assoc. with bipolar disorder

A

ANK3
NRG1
G72
G30

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14
Q

what causes bipolar

A

80% genetic component and onset due to trigger e.g. stress

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15
Q

what syndrome is bipolar assoc. with

A

Di George Syndrome (22q11.2)

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16
Q

what is bipolar I

A

has met criteria for manic episode once

previous episodes may have been depressive or hypomanic

17
Q

what is bipolar II

A

current or past history of at least one episode of hypomania and current or past history of at least one episode of depression but has never met criteria for mania

18
Q

what is the more common type of bipolar

A

II

19
Q

what is mania without psychotic symptoms (ICD-10)

A

absence of hallucinations or delusions although perceptual disorders may occur e.g. subjective hyperacusis or appreciating colours as especially vivid

20
Q

what is mania with psychotic symptoms (ICD-10)

A

delusions or hallucinations are present (other than typical schizophrenic)
most common are grandiose, self referential, erotic or persecutory

21
Q

what is mixed affective disorder

A

mania and depression features in the same day

22
Q

what is cyclothymia

A

chronic mood disturbance assoc. with numerous episodes of mild hypomania and depression but episodes arent long enough or severe enough to meet criteria for bipolar

23
Q

what is rapid cycling

A

4 or more eps of mood disturbance in a year

24
Q

what is the 1st line treatment in acute mania

A

antipsychotic

- quetiapine/olanzapine/risperidone

25
Q

what is the 1st line treatment in acute bipolar depression

A

antipsychotic (quetiapine / olanzapine)

+ antidepressant (fluoxetine)

26
Q

1st line bipolar maintenance treatment

A

lithium