Bipolar disorder Flashcards
What is the definition of Bipolar disorder?
Bipolar disorder is a cyclical mood disorder that fluctuates between episodes of mania and depression.
According to DSM-V what are the different types of bipolar?
- Bipolar I disorder
- Bipolar II disorder
- Cyclothymia
What is Bipolar I?
Periods of severe mood episodes from mania to depression.
What is Bipolar II?
A milder form of mood elevation, involving milder episodes of hypomania that alternate with periods of severe depression.
What is cyclothymia?
Describes brief periods of hypomanic symptoms alternating with brief periods of depressive symptoms that are not as extensive or as long-lasting as seen in full hypomanic episodes or full depressive episodes.
What are the types of episodes?
- Manic
- Hypomanic
- Depressive
What are the risk factors?
- Family history
- Neurological abnormalities
- Stress
- Social factors
What are the features of a manic episode?
- Abnormally elevated mood, extreme irritability, and sometimes aggression
- Increased energy or activity, restlessness, and a decreased need for sleep
- Pressure of speech or incomprehensible speech.
- Flight of ideas or racing thoughts.
- Distractibility, poor concentration.
- Increased libido, disinhibition, and sexual indiscretions.
- Extravagant or impractical plans (for example business investments, spending sprees).
- Psychotic symptoms: delusions (usually grandiose) or hallucinations (usually voices).
What are the features of a hypomanic episode?
- persistent mild ↑ mood increased energy
- ↑ sociability, talkativeness and overfamiliarity
- Increased energy and activity, which may lead to increased performance at work or socially.
- Feelings of well-being, or physical and mental efficiency.
What differentiates a manic and hypomanic episode?
Hypomania
- lesser degree of mania that is not severe enough to cause marked impairment in function
- No hallucinations or delusions, requiring
- At least 4 days
Mania
- Impairment in functioning
- At least 7 days
What is required in a diagnosis of Bipolar affective disorder?
Bipolar affective disorder: at least two mood episodes, one of which must be mania or hypomania.
What is required in a diagnosis of Bipolar I?
At least one manic episode.
Depression episode not required for diagnosis.
What is required in a diagnosis of Bipolar II?
At least one major depressive episode and one major hypomanic episode.
What is required in a diagnosis of cyclothymia?
Chronic mood disturbance with depression and hypomanic symptoms that do not meet criteria for a full episode.
Pharmaceutical treatment ?
- Antipsychotics: used as therapeutic trial to treat mania. May be switched to mood stabiliser once acute episode resolved.
haloperidol, olanzapine or quetiapine. - Long term mood stabiliser - • Lithium
- Antiepileptics - used as mood stabilisers. May be used alone or in combination. Help prevent depression relapses.
valproate, lamotrigine or carbamazepine. - Antidepressants: may be restricted due to risk of inducing mania or rapid-cycling (frequent, distinct episodes).
