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Y3R3 - Psychiatry 🧠 > L6: Bipolar Disorder > Flashcards

L6: Bipolar Disorder Flashcards

1
Q

What are depressive and bipolar disorder are characterized by?

A

a primary disturbance in internal emotional state (mood), causing subjective distress and problem in social and occupational functioning.

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2
Q

A person may emotionally feel …..

A
  • Somewhat worse than would be expected (dysthymia).
  • Somewhat better than would be expected
    (hypomania).
  • Very much worse than would be expected (depression).
  • Very much better than would be expected
    (mania).
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3
Q

DSM separates Depressive Disorders & Bipolar Disorders into 5 types which are ……

A
  • Major depressive disorder
  • Bipolar Disorder
  • Persistent Depressive Disorder
  • Cyclothymic Disorder
  • Depressive & Bipolar Disorders due to another medical condition and substance/medication induced depressive and bipolar disorder can be considered secondary mood disorders.
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4
Q

Major depressive disorder (In Brief)

A

One or more episodes of depression, each continuing or at least 2 weeks.

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5
Q

Bipolar Disoerder (In Brief)

A
  • bipolar I disorder: Episodes of both mania (continuing or at least 1 week) and depression.
  • bipolar Il disorder: Both hypomania (continuing or at least 4 days) and depression.
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6
Q

Persistent Depressive Disorder (In Brief)

A

Dysthymia or depression continuing over a 2 year period (1 year in children) with no discrete episode of illness

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7
Q

Epidemeology of Mood Disoredrs

A
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7
Q

Cyclothymic depressive Disorders (In Brief)

A
  • Hypomania and dysthymia occurring over a 2-year period (1 year in children) with no discrete episode of illness.
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8
Q

Clinical Features of MDD

A
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9
Q

what do patients with Masked Depression complain from?

A

Patients with masked depression often visit primary care doctors complaining of vague physical symptom.

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9
Q

Incidence of Masked Depression

A

As many as 50% of depressed patients seem unaware of or deny depression and they are said to have”masked depression”.

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10
Q

In contrast to patients who have somatic symptom disorders (who have physical symptoms resulting from psychological factors), depressed patients show …….

A

at least one SWAG symptom of depression in addition to their physical complaints.

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11
Q

Charactesr of Masked Depression

A
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12
Q

what is Depression With Seasonal Pattern associated with?

A

late autumn and early winter season and short days.

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13
Q

what is Depression With Seasonal Pattern Characterized by?

A

atypical symptoms of depression (e.g. oversleeping and overeating [particularly a craving or carbohydrate-rich foods]) and a heavy feeling in the limbs (“leaden paralysis”).

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14
Q

TTT of Depression With Seasonal Pattern

A

Patients with the short-day type of DSP may improve in response to full-spectrum light exposure with or without antidepressant medication.

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15
Q

Characters of Depression With Seasonal Pattern

A
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16
Q

Symptoms of PMDD

A

mood lability, dysthymia and anxiety occurring in the week preceding menses and minimal or absent in the week post menses.

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17
Q

Time of Symptoms of PMDD

A
  • Symptoms were present in most menstrual cycles in the preceding year.
  • This type of mood disorder occurs seven to 10 days before menstruation and goes away within a few day of the start of the menstrual period.
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18
Q

Characters of PMDD

A
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19
Q

Suicide Risk in depression

A
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20
Q

Most adults with depression do not see a mental health professional, but they often present to a primary care physician for other reasons

A

…..

21
Q

Triad for Depression with seasonal pattern

A
  • Irritability
  • Carbohydrate craving
  • Hypersomnia
21
Q

The postpartum period conveys an ……. of depression in women.

A

elevated risk

22
Q

Bereavement

A
23
Q

Clinical Features of Bipolar

A
24
Q

DSM5 Cr of Bipolar

A
25
Q

In contrast to major depressive disorder and bipolar disorder respectively, persistent depressive disorder (dysthymic) and cyclothymis disorder are ……

A
  1. Non episodic.
  2. Chronic (last tor at least two years).
  3. Symptoms may occasionally lessen in severity during this time
  4. Rarely associated with psychosis or suicide.
26
Q

Compare between mania & Hypomania

A
27
Q

what is Rapid Cycling

A

the occurrence of four or more mood episodes (major depressive, hypomanic, or manic) in 1 year.

28
Q

If there has been a full manic episode, even in the past, or if the patient ever has a history of psychosis, then the diagnosis is ………

A

bipolar I, not bipolar Il disorder.

29
Q

DSMs diagnostic criteria of cyclothymic disorder

A
30
Q

Etiology of Mood Disorders

A
  • Biologic etiology of depressive and bipolar disorders
  • psychosocial etiology of depression and dysthymia
  • Psychosocial factors are not directly involved in the etiology of mania or hypomania.
31
Q

Biologic etiology of Mood Disorders

A
  1. Altered neurotransmitter activity.
  2. Physical illness and related factors.
  3. Abnormalities of the limbic-hypothalamic-pituitary-adrenal axis.
  4. A genetic component, strongest in bipolar disorder
32
Q

Genetic component in Bipolar Disorder

A
33
Q

Psychological Etiology of depression & Dysthmia

A
  1. Loss of a parent in childhood.
  2. Loss of a spouse or child in adulthood.
  3. Loss of health.
  4. Low self-esteem and negative interpretation of live event.
  5. “Learned helplessness” (i.e. because attempt to escape bad situation in the past have proven futile, the per on now feels helpless ).
34
Q

Only about …. of patient with depression seek and receive treatment, Because ………

A

25%

  • Patient do not seek treatment in part because Americans often believe that mental illness indicate personal failure or weakness.
  • As in other illnesses women are more likely than men to seek treatment.
34
Q

DDx of Mood Disorders

A
35
Q

Depression is successfully managed in most patients

A

..

36
Q

Untreated episodes of depression and mania are usually ……..

A

self-limited and last approximately 6-12 months and 3 months, respectively.

37
Q

The most effective management of depressive and bipolar disorder is ……

A

pharmacologic, but Psychological management in conjunction with medication is more effective than either type of management alone.

38
Q

Pharamacological TTT of Bipolar Disorder

A
39
Q

Psychological TTT of Bipolar Disorder

A

Psychological management of depression and dysthymia includes:
- psychoanalytic, interpersonal, family, behavioral, and cognitive therapies.

40
Q

The primary indication of ECT is …..

A

major depressive disorder.

41
Q

When is ECT used?

A
  1. The symptoms do not respond to antidepressant medications.
  2. Antidepressant are too dangerous or have intolerable side effects. Thus ECT may be particularly useful or elderly patients.
  3. Rapid resolution of symptoms is necessary (e.g. the patient is acutely suicidal or psychotic)
42
Q

…… remains the gold standard in treatment of bipolar disorder, particularly due to …….

A

Lithium, due to demonstrated reduction in suicide risk.

42
Q

Major depression with psychotic features is best treated with …….

A

a combination of an antidepressant and antipsychotic, or ECT.

43
Q

TTT of Acute mania

A
  • Atypical antipsychotics (e.g., risperidone) are effective as both monotherapy and adjunct therapy for acute mania.
  • In fact, many patients (especially with severe mania and/or with psychotic features) are treated with a combination of a mood stabilizer and antipsychotic; studies have shown a greater and faster response with combination therapy.
44
Q

Why are Antidepressants discouraged as monotherapy for bipolar Disorder?

A
  • Antidepressants are discouraged as monotherapy due to concerns of activating mania or hypomania.
  • They are occasionally used to treat depressive episodes when patients concurrently take mood stabilizers.
45
Q

ECT is especially effective for refractory or life-threatening acute mania or depression.

A

….

45
Q

….. is the best treatment for a pregnant woman who is having a manic episode. It provides a good alternative to antipsychotics and can be used with relative safety in all trimesters.

A

ECT

46
Q

Compare between Mania & Depression in terms of:

  • Energy
  • Sleep
  • Thoughts & Feelings
  • Speech & Sensation
  • delusions & Hallucinations
A
47
Q

There are 3 basic types of bipolar disorder:

A
  1. Bipolar |
  2. Bipolar II
  3. Cyclothymia
48
Q

Treatment of Bipolar Disorder will depend on the specific illness and symptoms that are present.

A

….

Y3R3 - Psychiatry 🧠 (19 decks)

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