Bipolar Disorder intro

Question 1

Epidemiology: prevalence, onset, sex, race

Answer 1

Prev: 2.4%
Onset: late adolescence and young adulthood
Avg: 25yo
Sex and race are pretty equal though BP1 M>F and BP2 F>M

Question 2

Proportion of mood disorders

Answer 2

Now about 50% due to changing spectrum

Question 3

etiology genetic risk

Answer 3

Genetic risk 5-10% in 1st deg

Question 4

etiology neurological etc

Answer 4

Many:
Brain derived neurotrophic factor (BDNF)
COMT
Monoamine
NE, S, D
CACNA1C
GABA receptors

prenatal infection T.gondii

Question 5

DDX

Answer 5

substance use: Alcohol and drugs

Rx induced: steroid, antidepressant

medical illness: thyroid

Other psych dx: Schizo, MDD

Question 6

risk factors

Answer 6

childhood maltreatment

Psych stress

Substance misuse

Question 7

comorbidities

Answer 7

Anxiety- 24-56%
Personality: 42%
ADHD: 10-20%
SUD: 33%
Metabolic disorder: 20-65%

Question 8

Suicide risk

Answer 8

43% SI
21% plan
16% attempt in the last year
6-7% death by suicide

Question 9

goals of tx

Answer 9

eliminate episode
prevent recurrence
minimize AE
patient compliance

Question 10

available guidelines

Answer 10

CANMAT 2018
NICE 2014 (2018 update)
TMAP 2007
APA 2002 (update 2005)