Bipolar disorders Flashcards
Key feature of bipolar disorders?
- Periods of mania alternate with periods of depression
- Emotional roller- coaster: elation to despair to elation to despair…
- “Manic depression” = old name for bipolar disorders
Manic episode (DSM-5 definition)
A distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary)
3 or more of the following (4 if mood is only irritable):
Inflated self-esteem or grandiosity
Decreased need for sleep
Atypically talkative
Flight of ideas or subjective experience of racing thoughts
Distractibility as reported or observed
Increase in goal-directed activity (socially, at work, or sexually) or psychomotor agitation (purposeless non-goal-directed activity)
Excessive involvement of activities with a high potential for painful consequences (e.g., unrestrained buying sprees, sexual indiscretions, foolish business investments)
The mood disturbance is sufficiently severe to cause a marked impairment in social or occupational functioning
- OR necessitates hospitalization to prevent harm to self or others
- OR there are psychotic features
Not substance induced
Manic episode : at least 3 of following…
Inflated self-esteem or grandiosity
Decreased need for sleep
Atypically talkative
Flight of ideas or subjective experience of racing thoughts
Distractibility as reported or observed
Increase in goal-directed activity (socially, at work, or sexually) or psychomotor agitation (purposeless non-goal-directed activity)
Excessive involvement of activities with a high potential for painful consequences (e.g., unrestrained buying sprees, sexual indiscretions, foolish business investments)
Hypomanic episode DSM 5 criteria
Same as manic episode BUT
- Lasting at least 4 consecutive days vs. at least 1 week
- Episode is NOT severe enough to caused a marked impairment in social/occupational functioning or necessitate hospitalisation; NO psychotic features
+ Disturbance in mood or functioning is unequivocal and observable by others
What are the three main categories of bipolar disorders?
- Bipolar 1: manic episodes, typically alternating with MDEs
- Bipolar 2: Hypomanic episodes (which must be) alternating with MDEs
- Cyclothymia: Hypomanic symptoms (not episodes) alternating with hypodepressive symptoms
Bipolar 1 diagnostic criteria?
- At least one manic episode; but over 90% have recurrent episodes
- MEs typically alternate with MDEs
- Manic symptoms can by psychotic, but typically not
Bipolar 1 prevalence?
12 month prevalence - 0.6% in USA
Bipolar 1 typical onset?
~18 years
Bipolar 1 length of mood episode?
2-6 months
- Rapid cycling: 4 or more mood episodes in previous 12 months (2 or more ‘cycles;
Bipolar 2 criteria?
- Hypomanic episodes alternate with MDEs
- Approx 15% of bipolar 2 -> bipolar 1
Bipolar 2 prevalence?
12 month prevalence - 0.8% in USA
Bipolar 2 typical onset?
Mid 20s
Bipolar 2 length of mood episode?
- Tend to be shorter
- More likely to be rapid cycling
Cyclothymia?
Recurrent periods of hypomanic symptoms alternating with hypodepressive symptoms, over at least a 2 year period
- Criteria for manic, hypomanic, and MDEs have never been met
Chronic, low-level symptoms
Cyclothymia prevalence/ onset?
0.4% - 1% in USA; adolescence / early adulthood
