Bipolar & Related Disorders

Question 1

Diagnostic Criteria for Bipolar I (AKA “manic depression”)

Answer 1

Must have at least 1 manic episode
Not necessary to have a depressive episode for diagnosis

Question 2

What is a Manic Episode? (8)

Answer 2

Abnormally elevated mood (or irritability) AND increased activity or energy PLUS 3 symptoms
1. Inflated self-esteem
2. Decreased NEED for sleep
3. Pressured speech
4. Flight of ideas
5. Distractibility
6. Increased goal-directed activity
7. Excessive involvment in “risky” activities

Question 3

How long must symptoms last in a Manic Episode?

Answer 3

1 week OR if hospitilization is required
-causes marked functional impairement

Question 4

Course of Illness in BPI

and differential diagnosis

Answer 4

1. Manic episodes usually occur directly before/after an MDE
2. Manic episodes last approx 3 months

Must rule out a medical condition (hyperthyroidism), or substance use/intoxication

Question 5

Etiology of BP I

Answer 5

1. Strong genetic component
2. Manic episodes have increased monoaminergic activity (dopamine)

Question 6

Treatment of BP I

Answer 6

1. Mood stabilizers (Lithium, anticonvulsants, antipsychotics)
2. ECT-w/ treatment resistant
3. Psychotherapy for secondary issues

Antidepressants are NOT FDA approved-contraindicated

Question 7

Diagnostic Criteria for BP II

Answer 7

• MDE
• Hypomanic episode

Question 8

Does hypomania or mania cause marked functional impairement?

Answer 8

Mania

Question 9

Hypomanic Episode symptoms and duraction

Answer 9

1. Same symptoms of mania
2. Must last for greater than 4 days

Question 10

Treatment of BP II

Answer 10

1. Mood stabilizers

Question 11

What is Cyclothymic Disorder?

Answer 11

Fluctation of hypomania and dysthymia for greater than 2 years
Criteria for MDE or manic episode have never been met

Question 12

Treatment for Cyclothymia

Answer 12

Mood stabilizers