Mania Flashcards
Sequence of events
Open question
Clarify- what are your/ your partners concerns?
Timeline- gotten worse
Key features of mania
Distractibility
Impulsivity (libido, spending money)
Grandiosity- special powers abilities or ideas
Flight of ideas
Activity- increase
Sleeplessness
Talkativeness
NB- say some of these out loud to the patient so the examiner knows that you are observing them
Risk
Overspending- shopping binges, finances
Police- any trouble recently
Self harm or suicide eg, if they believe they can fly, have they tried that out?
Risk to others?
Systems review
Psychosis- auditory hallucinations/ visual hallucinations/ altered sensations/ delusions of thought and control
Depression- mood/anhedonia/ sleep/ future (have you ever been low in mood- if considering BAD as a diagnosis)
Others- memory loss/ anxiety/ insight/ relationship with food
Patients perspective
Feelings and impact on life
ICE
Insight
PMH
Medical or psych
Thyroid?
DH
Regular
OTC
Allergies
SH
Job- what does it involve. Impact on job
Home situation- occupants and difficulties
How is mood affecting home life
Support from family or friends
Smoke alcohol recreational drugs
Have you been looking after yourself and the home eg. showering and cleaning
Mania
Extreme version of the signs and symptoms outlined earlier
In exam say things like “you seem to talk very fast” “you seem to have lots of ideas” “you seem to have special powers”
Hypomania
Milder form of mania with slightly elevated mood that alternates with irritability, high energy levels and restlessness
Delusions hallucinations not present
NB- not immediate cause for concern (mania is- think of people I saw in Park House, that’s the mania you would be worried about ie. Major risk to themselves or others)
BAD
Manic Sx in someone with a previous history of depression
Schizoaffective disorder
History of manic and I’d depressive Sx concurrent with Sx of schizophrenia
Drug induced psychosis
Mimic psychosis
Adjustment disorder
Insomnia, poor concentration, avoiding important jobs, skipping school and work
Low mood and anxiety in the context of an identifiable stressor
DVLA
Tell DVLA can’t drive
