Elated Mood Flashcards
Difference between DSM (BP I and II) and ICD (hypomania, mania w/o psychotic, mania w/ psychotic) definitions of bipolar disorder?
DSM describes course and pattern,
ICD describes episode severity
Bipolar I
Underlying depression with interspersed episodes of mania (has to have met criteria for mania)
Bipolar II
depression is more dominant, hypomania (never met criteria for mania) and episodes may be precipitated by antidepressants
Which is most common - BP I or BP II?
BP II
BPAD in ICD-10 definition
2 or more episodes in which patient’s mood is disturbed consisting sometimes of hypomania/mania and on others depression.
Repeated episodes of hypomania/mania only are classified as bipolar.
Repeated or single episodes of hypomania or mania only are classed as bipolar. T/F?
True - even without depression
Hypomanic episode ICD-10 criteria (mood description, timing, how many signs)
elevated mood that is abnormal for the individual,
sustained for at least 4 consecutive days,
at least 3 signs of hypomania
At least 3 signs of hypomania must be present for diagnosis. List 6
increased activity, increased talkativeness, difficulty concentrating, decreased need for sleep, increased sexual energy, reckless behaviour e.g. mild spending spree
Manic episode ICD-10 criteria (mood description, timing, how many signs)
Predominantly elevated mood that is definitely abnormal for the individual,
sustained for at least 1 week (unless hospitalised),
at least 3
At least 3 signs of mania must be present for diagnosis. List 9
increased activity,
increased talkativeness,
decreased need for sleep,
flight of ideas or thoughts racing,
loss of normal social inhibitions so abnormal social behaviour,
inflated self-esteem,
distractibility or constant changes in plans,
reckless behaviour more extreme than mania,
marked sexual energy or
List 3 signs of hypomania/mania in appearance and behaviour in MSE
bright clothes,
distractibility,
loss of normal social inhibitions
List 2 signs of hypomania/mania in speech in MSE
increased talkativeness,
puns and clang associations
List 4 signs of hypomania/mania in thoughts in MSE
increased flow,
flight of ideas,
loosening of associations,
grandiosity
Bipolar disorder more common in men or women?
Women
Prevalence of BPAD?
1-4%
BPAD usual age on onset?
late teens or early 20s
Unipolar depression usual age of onset?
30s
Mania without psychotic symptoms presents how?
no hallucinations or delusions but may have perceptual disorders e.g. subjective hyperacusis
Mania with psychotic symptoms presents how?
delusions or hallucinations are present but not the ones that are typical for schizophrenia so commonly grandiose, self-referential, erotic or persecutory
Presentation over age of 60 is rare and usually indicates what?
treatment-resistance and an underlying organic cause
What is approximate increase in risk of BPAD if family member has depression/bipolar?
5-10%
Multiple genes are thought to play a role in development of BPAD along with environment. What one specific genes has been identified as associated with rapid cycling bipolar disorder?
COMT
Common comorbidites with BPAD?
anxiety disorders, alcohol and drug misuse, personality disorders, eating disorders, schizoaffective disorder, schizophrenia
Patients with BPI and BPII typically spend approximately _% of the time with syndrome mood disturbance?
50%
In both types, which is the most common mood disturbance?
Depression
Less than 5% of follow up is spent being high in BP I/II and less than 15% of follow up is spent being high in BP I/II?
5% - BP II,
15% - BP I
Predictors of poor outcome in adolescence
early onset,
low socioecnomic status,
BPAD carries an increased risk of suicide - T/F?
T
