Bipolar & Related Disorders

Question 1

Bipolar I disorder is characterized by:

Answer 1

A manic episode preceded or followed by a hypomanic or major depressive episodes

Definitions
* Manic episode - symptoms last at least 1 week and has at least 3 of the following symptoms:
- Grandiosity
- Decreased sleep
- Garrulousness (excessively talking)
- Rapid thoughts
- Difficulty concentrating
- Agitation
- Restlessness
- Increased goal directed activity
- Increased engagement in risky behaviors (I.e. gambling, business ventures, etc.)

• Hypomanic episode- like manic but symptoms lasts at least 4 days
• Major depressive episode - at least 5 of the following symptoms last for a 2-week period:
  • Persistent negative mood
  • Diminished satisfaction/pleasure from most activities
  • Significant weight loss
  • Insomnia/hyperinsomnia
  • Agitation
  • Fatigue
  • Feeling worthless
  • Difficulty concentrating
  • Suicidal ideation

Question 2

Bipolar I disorder is often treated by the following pharmaceuticals:

Answer 2

Mood stabilizers - to manage mania
* Lithium (Lithobid)
* Valproic acid (Depakene)
* Divalproex sodium (Depakote),
* Carbamazepine (Tegretol, Equetro, etc.)

Antipsychotics
* Olanzapine (Zyprexa)
* Risperidone (Risperdal)
* Quetiapine (Seroquel)
* Aripiprazole (Abilify)
* Lurasidone (Latuda)

Antidepressants
- Because an antidepressant can sometimes trigger a manic episode, it needs to be prescribed along with a mood stabilizer or antipsychotic in bipolar disorder

Antidepressant-antipsychotic.
* Symbyax (combines the antidepressant fluoxetine and the antipsychotic olanzapine) is approved by the FDA for the treatment of depressive episodes associated with bipolar I disorder

Question 3

The following therapies are recommended for people diagnosed with Bipolar I Disorder:

Answer 3

• CBT
• Psychoeducation
• Family therapy
• Psychotherapy
• Interpersonal therapy
• Behavioral couples therapy

Question 4

People are diagnosed with Bipolar II Disorder when:

Answer 4

They meet the criteria for both a current/previous hypomanic episode (3 symptoms related to elevated mood for 4 consecutive days) and current/previous major depressive episode (at least 5 symptoms for 2 weeks)

Question 5

Cyclothymic disorder is:

Answer 5

A person experiences symptoms of hypomania and depression w/o meeting criteria for at least 2 years (symptoms must be present at least half the time with no more than 2 months between episodes)

Question 6

The following assessment tools can be used to diagnose a client with bipolar disorder:

Answer 6

• Bech-Rafaelsen Mania Rating Scale (MAS)
• Quick Inventory of Depressive Symptomatology (QIDS)
• Bipolar Inventory of Symptoms Scale (BISS).

Electronic self-monitoring of depression:
* Montgomery Asberg Depression Rating Scale (MADRS)
* Hamilton Depression Rating Scale (HDRS)
* Inventory of Depressive Symptomatology (IDS

Question 7

The following assessment tools can be used to diagnose a client with bipolar disorder:

Answer 7

• Bech-Rafaelsen Mania Rating Scale (MAS)
• Quick Inventory of Depressive Symptomatology (QIDS)
• Bipolar Inventory of Symptoms Scale (BISS).

Electronic self-monitoring of depression:
* Montgomery Asberg Depression Rating Scale (MADRS)
* Hamilton Depression Rating Scale (HDRS)
* Inventory of Depressive Symptomatology (IDS