Bipolar disorder lect 6

Question 1

bipolar disorders is also known as

Answer 1

manic depressive disorder

Question 2

the definition of mania

Answer 2

-inflated self esteem/grandiosity
-decreased need for sleep
-pressured speech/talkative
-racing thoughts
-distractibility
-hyperactivity with increase goal directed actions or agigtiation w non goal directed actions
-excessive involvement in activites w painful consequences ( such as spending alot)

Question 3

pressured speech

Answer 3

accelerated/uncontrolled speech that often occurs in context of hypomanic/manic episode.

Question 4

manic episode

Answer 4

-present at least 7 days
-impairment of social and occupational fxn
-3 + manic episodes described

Question 5

psychosis

Answer 5

-persons thoughts or perception are disturbed and the individual may have difficulty understanding what is real and what is not

Question 6

mixed episode

Answer 6

-sx of depression and mania/hypomania

Question 7

hypomanic episode :

Answer 7

-like a manic episode EXCEPT:
-duration is 4 days
-does NOT cause social or occupational impairment
-does not require hospitilization
-does not have psychotic features

Question 8

Bipolar DSM-5

Answer 8

meet the criteria of manic episodes:
-distinct pd. of irritability mood and increased of active energy

-during the period of mood disturbance and high energy activity, 3+ of sx are present [4 if irritable]:

-inflated self esteem
-decrease need for sleep
-more talkative than usual
-flight of racing ideas
-distracted easily
-increase in goal activity
-excessive involv’t of activities with painful consequences

Question 9

Bipolar MANIC EPIDOSDE 1 diagnoses:

Answer 9

-full manic episode during antidepressant tx but persists at full syndromal lvl BEYOND the psychological effect of tx

Question 10

the mood disturbance in sufficiently severe to cause MARKED IMPAIRM’T in social or occupational/hospitalizations:

Answer 10

-to prevent harm to self or to others

Question 11

HYPOMANIC bipolar dsm-5 c-f:

Answer 11

-unequivocal change in fxning that is uncharacteristic of the individual when not symptomatic.

-disturbance in mood and change in fxning are observed by others

-not attributed to psychological effects of a substance

-caution is indicated for those on antidepressants effects that can cause mani c episodes so they are not taken sufficient for diagnosis.

Question 12

bipolar major depressive episode is the same as

Answer 12

MDD:
where they are in depressed mood and loss of interest or pleasure

Question 13

bipolar disorder 1:
bipolar disorder 2:

Answer 13

-manic episodes, mixed episodes

2: hypomanic episodes

Question 14

Bipolar disorder 1:

Answer 14

one manic episode causing social/occupational impairment

Question 15

bipolar disorder type 2:

Answer 15

chronic depression with one HYPOmanic episode

Question 16

cyclothymic disorder

Answer 16

recurrent hypomanic disorders or depressive sx but NEVER meet criteria of manic or depressive episodes, span of 2 yrs and never absent for more than 2 months at a time

Question 17

GAD

Answer 17

related to hypomania BUT more EMPHASIZES ON WORRY

Question 18

Depressive disorder

Answer 18

depressed or anhedonic mood

Question 19

PTSD

Answer 19

hx of trauma and severe anxiety

Question 20

psychotic disorder

Answer 20

hallucinations and or delusions

Question 21

substance use disorder

Answer 21

possible mania or depression, linked to substance

Question 22

borderline personality disorder

Answer 22

sx similiar to mania, hypomania, or depressed mood

Question 23

medical conditions that mimic BIPOLAR disorder:

Answer 23

-uncontrolled thyroid
-frontal lobe pathology: [tumors, injury, cogenital defects]
-medications :thyroxine, corticosteroids ,isoniazid, levodopa

Question 24

medications that mimic bipolar disorder

Answer 24

-thyroxine
-corticosteroids
-isoniazid
-levodopa

Question 25

bipolar disorder:

age?
race?
percent?

Answer 25

-20-30 yrs old
-NA-white-AA-hispan.-asian
1.5%

risk in first degree relative is 5-10%

Question 26

pharmacological tx:

mood stabilizers

Answer 26

-lithium
-lamotrigine
-divalproex
-carbamazepine

Question 27

pharmacological tx:

Atypical antipsychotics

Answer 27

-quetiapine
-risperidone
-aripiprazole
-ziprasidone
-olanzapine

Question 28

Lithium

Answer 28

-best bipolar tx

-reduces risk of suicide
-narrow therapeutic window for side affects such as : nausea, sleepy, slurred speech, confusion,

Question 29

lithium SA:

long term:

Answer 29

SA: polyuria, polydipsia, tremor, weight gain, edema

-teratogen:
ebsten anomaly:malposiiotn of the tricuspid valve

Question 30

FDA approved what med. for monotherapy:

Answer 30

-quetiapine XR
-seroquel XR

Question 31

suicide:
global# deaths
U.S deaths:

% of attempt

Answer 31

-800,000
-18th leading cause of death
-US- 40,000
5% will have attempted
20-30:1 Ratio

Question 32

males and female suicide statistics:

ethnicity:

Answer 32

-males use deadlier means

females: greater number of doses

NA>white> hisp.>AA

Question 33

avg. age of death in suicide

what is the 2 nd leading cause of death for ages 15-34?

Answer 33

males >75
f: 45-64

suicide

Question 34

Suicide risk factors

Answer 34

-recent loss of spouse, child, job

-worsening of dx: mental, substance abuse, health cond

adverse life event:
bullied, break up, arrest

Question 35

suicide protect factors:

Answer 35

-social support system, religious affiliation, married, children

Question 36

screening for suicide:

Answer 36

-PHQ9
-* P4 screener:pasthx, plan, probabiltiy, preventative factors

Question 37

suicide intervention/prevention:

Answer 37

-ask empathetically
-about their specific plans, harmful ideas will to live

Question 38

if pt has a plan and is certain about suicide, you must:

Answer 38

-immediate referral to psychiatric eval

-inpatient ED
-CAN BE AGAINST PT WILL

Question 39

certificate of emergency 6404:

Answer 39

-emergent INVOLUNTARY admission

1st part: put pt in psychiatric facilty then admit to ed, TX is NECESSARY

Question 40

45% of pts commit suicide who seen health care provider last month