elevated mood

Question 1

Is elevated mood in itself pathological?

Answer 1

No, in combo with other signs/symptoms may be

Question 2

In what psychiatric disorder does elevated mood almost always occur with?

Answer 2

bipolar affective disorder

- but other disorders also feature it

Question 3

What are the 5 different states of elevated mood?

Answer 3

¥	Hypomania
¥	Mania without psychotic symptoms
¥	Mania with psychotic symptoms
¥	Mixed affective state
¥	Cyclothymia

Question 4

describe the speech assoc. with elevated mood

Answer 4

fast/pressurised/flight of ideas/incomprehensable speech

Question 5

describe energy levels assoc. with elevated mood

Answer 5

excessive/overactivity/descreased need for sleep

Question 6

describe the thought content assoc. with elevated mood

Answer 6

grandiose/self-confident/delusions of wealth, power, influence
religious significance
sometimes can be persecutory

Question 7

describe the cognition assoc. with elevated mood

Answer 7

disturbance of registration of memories

Question 8

describe physical symptoms assoc with elevated mood

Answer 8

insomnia/mild-mod. weight loss/increase libido/ severe sustained physical activity/self neglect/dehydration

Question 9

describe behavior assoc with elevated mood

Answer 9

disinhibition/increase in sexual activity/excessive drinking and spending/distractable/risk taking/aggression

Question 10

describe typical hallucinations assoc. elevated mood

Answer 10

fleeting auditory

Question 11

What is mixed affective state?

Answer 11

A mixed (affective) state, also known as a "mixed episode" or, depending on the prominent "polarity," dysphoric mania or agitated depression, is a condition during which features of mania and depression—such as agitation, anxiety, fatigue, guilt, impulsiveness, irritability, morbid or suicidal ideation, panic, paranoia, pressured speech and rage—occur simultaneously or in very short succession.
•	A defining feature of bipolar I disorder

Question 12

What is hypomania?

Answer 12

no psychosis/milder symptoms in general
mild elevation of mood
Feelings of wellbeing and efficacy
increase in energy and activity
sometimes irritable
some disturbance of function

Question 13

Describe main differences between hypomania and mania?

Answer 13

Hypomania:

• lasts shorter time
• less severe
• no psychotic features
• less disability
• not hospitalised

Question 14

Describe the difference between hypomania and happiness

Answer 14

persistance - it is persistant
non- reactive - no provoked by good news or affected by bad
causes a social disability

Question 15

how to diagnose bipolar affective disorder?

Answer 15

2+ episodes of mania +/- depression

hypomania for bipolar 2

Question 16

What is bipolar 1 disorder and prevalence?

Answer 16

prevalence - 1%
-manic or mixed episodes lasting 7 days or more
or
-manic symptoms so severe need for hospital care immediately

usually depressive episodes occur too lasting usually 2+wks

Question 17

What is bipolar 2 disorder and prevalence?

Answer 17

prevalence - 1.5-5%

-pattern of depressive and hypomanic episodes, not full blown mania

Question 18

What is cyclothymia?

Answer 18

mild form of bipolar:

• episodes of hypomania and mild depression for at least 2 years
• persistant instability of mood
• need prolonged observation or good account of past behavior

Question 19

What is rapid cycling bipolar disorder?

Answer 19

SEVERE form bipolar disorder

• 4+ episodes in 1 year
• may be interspersed with some wellness
• cycling may take place in days/weeks/months

Question 20

what is the mean age onset and M:F ratio bipolar disorder

Answer 20

Mean age: 21yo

M:F 1:1

Question 21

Describe the aetiology of bipolar disorder

Answer 21

Individual vulnerability factors:
-genetics (1st deg. relative = 7fold risk)
Current factors:
- stressors/life events
-sleep deprivation
-drugs
-childbirth
-physical illness

Question 22

what is the prognosis for bipolar disorder?

Answer 22

median length of untreated episode - 3mths
frequency of episodes increase in 1st 10 years
12-15% lifetime risk suicide

Question 23

Describe 5 main causes for elevated mood?

Answer 23

1: organic
2: psychotic
3: affective (mood)
4: neurotic (anxiety)
5: personality

Question 24

What organic causes are there for elevated mood?

Answer 24

Neurological e.g. brain tumour
Endocrine e.g. hyperthyroid
inflammatory causes e.g. SLE
infective causes e.g. neurosyphillis
sleep disorder e.g. sleep deprivation
medication e.g. STEROIDS
drugs e.g. dexamphetamine (speed)

Question 25

what psychotic causes are there for elevated mood?

Answer 25

Schizoaffective disorder

Question 26

What is schizoaffective disorder?

Answer 26

A disorder in which the individual suffers from both symptoms that qualify as schizophrenia and symptoms that qualify as a mood disorder (e.g., depression or bipolar disorder) for a substantial portion (but not all) of the active period of the illness; for the remainder of the active period of the illness, the individual suffers from delusions or hallucinations in the absence of prominent mood symptoms.
Mental disorder characterized by the presence of both affective disorder and schizophrenia-like symptoms.
(some sx of schizophrenia/affective disorder but insufficient to justify either diagnosis)

Question 27

What developmental disorder is assoc. with elevated mood?

Answer 27

ADHD

Question 28

What kind of psychotic symptoms are experienced during an episode of mania with psychotic symptoms?

Answer 28

• mood congruent delusions – often grandiose/religious/suspicious
• mood congruent hallucinations e.g. a voice saying they’re incredibly important
• mood incongruent symptoms