Bipolar Disorders Flashcards
Criteria for Manic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
Distractibility
Insomnia, decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
Grandiosity or inflated self-esteem
Flight of ideas (or subjective experience that thoughts are racing)
Activities ( increase in goal-directed activity or psychomotor agitation)
Speech (more talkative than usual or pressure to keep talking)
Thoughtlessness (excessive involvement in pleasurable activities that have a high potential for painful consequences, impulsivity)
C. The symptoms do not meet criteria for a Mixed Episode.
D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
E. Not due to substance or GMC
Mixed episode
The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.
The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
The symptoms are not due to the direct physiological effects of a substance or a general medical condition.
Hypomanic episode
A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
D distractibility
I insomnia- decreased need for sleep
G Grandoisity or inflated self-esteem
F flight of ideas or subjective experience that thoughts are racing
A activities - increase in goal-directed activity or psychomotor agitation
S speech- more talkative than usual or pressure to keep talking
T thoughtlessness - excessive involvement in pleasurable activities that have a high potential for painful consequences
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
F. Not substance induced or GMC
Bipolar I
Presence of at least one Manic or Mixed Episode
Manic/Mixed Episode(s) are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder NOS
Bipolar II
Presence (or history) of one or more Major Depressive Episodes.
Presence (or history) of at least one Hypomanic Episode.
There has never been a Manic Episode or a Mixed Episode.
The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Cyclothymia A B and C
A. For at least 2 years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Episode.
B. Never without symptoms for more than 2 months at a time during 2 years
C. No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during the first 2 years of the disturbance.
Note: After the initial 2 years, there may be superimposed Manic or Mixed Episodes (in which case both Bipolar I Disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive Episodes (in which case both Bipolar II Disorder and Cyclothymic Disorder may be diagnosed).
D. The symptoms in Criterion A are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
E. The symptoms are not due to the direct physiological effects of a substance or a general medical condition.
F. Cause significant distress or impairment in social, occupational, or other important areas of functioning.
Differentials for bipolar
MDD substance related mood disorder mood disorder due to GMC Schizophrenia/Schizoaffective disorder Personality disorders ADHD
effective psychosocial tx
family focused treatment: focuses on expression emotion w/o family, psychoeducation
Interpersonal and social rhythm therapy: life event sthat may trigger episodes, minimize sleep disruptions, hleps to increase time between episodes
CBT: focus on cognitions and beliefs related to med compliance- modest support, better for those in early stages
