Elevated Mood Flashcards
Define bipolar I
One or more previous episode of mania, classic manic-depressive psychosis
Define bipolar II
Current/past hypomania episode and current/past depressive episode - never met the criteria for mania
Define bipolar III
Hypomanic episodes when on antidepressants
Define bipolar
A disorder characterised by two or more episodes in which the patients mood and activity levels are significantly disturbed - hypomania or mania and on others depression
Describe hypomania
Level of disturbance just below mania elevated mood or irritable to an abnormal degree sustained for at least 4 days - somewhat interferes with personal functioning and at least three others symptoms
What are the other symptoms of hypomania?
- Increased activity
- Increased talkativeness
- Concentration problems
- Decreased need for sleep
- Increased sexual energy
- Mild spending sprees
Describe mania
Elevated, expansive or irritable abnormal mood, prominent and sustained for one week - severe interference with daily life and three associated symptoms
What are the associated symptoms of mania?
- Increased activity
- Increased talkativeness
- Flight of ideas, racing thoughts
- Loss of social inhibitions
- Decreased need for sleep
- Inflated self-esteem/grandiosity
- Distractibility/constant change
- Reckless, dangerous behaviour
- Marked sexual energy/indiscretions
What appearance/behaviour will be observed?
Bright clothes, distracted, overfamiliarity
What speech changes will be observed?
Increased talkativeness, punning (rhyming), clang associations
What is the lifetime prevalence of bipolar disease?
1-4%
When does bipolar usually start?
Late teens/early 20s
Describe anticipation
Family history leads to younger onset with a more problematic course of disease
After what age is an organic pathology more likely?
60 years old
State the comorbidities associated with bipolar
Anxiety, alcohol/drug misuse, personality disorder, eating disorders, schizoaffective, schizophrenia
Define subsyndromal symptoms
Symptoms that alone would not meet the criteria but make the illness worse
What can make bipolar worse? How is this prevented?
Antidepressants - mood stabilisers can help
State the indicators of poor outcomes in bipolar
Early onset, socioeconomic status, syndromal symptoms, long duration, rapid mood fluctuations, mixed presentation, psychosis, comorbid disorders, family psychopathology
What is the risk of suicide in bipolar patients?
Up to 8%
