Bipolar Disorder Flashcards
how does ICD 10 describe bipolar disorders
based on severity:
- hypomania
- mania with psychotic features
- mania without psychotic features
how does DSM V describe bipolar disorders
based on course and pattern
- Bipolar I and II
- cyclothymic disorder
what is bipolar affective disorder (ICD-10)
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
a single episode of hypomania/mania in the absence of a history of depression is why
bipolar disorder - even if no history of depression
the first episode of hypomania/mania on a background of depression makes it what
bipolar disorder
hypomanic episode lasts for at least ____
4 days
manic episode lasts for at least ____
1 week
or hospitalised
what is hypomania
mood that is elated and irritable to a degree that is definitely abnormal for that individual and sustained for at least 4 days consecutively
what is mania
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
what is the criteria for hypomania (6)
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
what is the criteria for mania (9)
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
what is the average age of onset of bipolar disorder
21 (late teens - early 20s)
what genes are assoc. with bipolar disorder
ANK3
NRG1
G72
G30
what causes bipolar
80% genetic component and onset due to trigger e.g. stress
what syndrome is bipolar assoc. with
Di George Syndrome (22q11.2)
what is bipolar I
has met criteria for manic episode once
previous episodes may have been depressive or hypomanic
what is bipolar II
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
what is the more common type of bipolar
II
what is mania without psychotic symptoms (ICD-10)
absence of hallucinations or delusions although perceptual disorders may occur e.g. subjective hyperacusis or appreciating colours as especially vivid
what is mania with psychotic symptoms (ICD-10)
delusions or hallucinations are present (other than typical schizophrenic)
most common are grandiose, self referential, erotic or persecutory
what is mixed affective disorder
mania and depression features in the same day
what is cyclothymia
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
what is rapid cycling
4 or more eps of mood disturbance in a year
what is the 1st line treatment in acute mania
antipsychotic
- quetiapine/olanzapine/risperidone
what is the 1st line treatment in acute bipolar depression
antipsychotic (quetiapine / olanzapine)
+ antidepressant (fluoxetine)
1st line bipolar maintenance treatment
lithium
