Mood disorders- Mania and bipolar disorders Flashcards
What is mania?
A term to describe a state of feeling r mood that can range from near normal experience to severe, life threatening illness
Rarely a symptom, often associated with grandiose ideas, disinhibition, loss of judgement with similarities to the mental effects of stimulant drugs (AMH, cocaine)
Typically considered as a form of pathological inappropriate elevated mood
How does psychiatry assess mania
Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Presence of specific symptoms or signs
What are the various ICD-10 classifications of mania?
Hypomania Mania without psychotic symptoms Mania with psychotic symptoms Other manic episodes Manic episodes, unspecified
What is hypomania?
Lesser degree of mania, no psychosis
Mild elevation of mood for several days on end
Increased energy and activity, marked feeling of wellbeing
Increased sociability, talkativeness, overfamiliarity, increased sexual energy, decreased need for sleep
May be irritable
Concentration reduced, new interests, mild overspending
Not to the extent of severe disruption o work or social rejection
How do you classify mania?
Lasts at least 1 week and is severe enough to disrupt ordinary work and social activities. Mood more or less completely.
Elevated mood, increased energy, over activity, pressure of speech, decreased need fro sleep
Disinhibiotion
Grandiosity
Alteration of senses
Extravagant sending
Can be irritable rather than elated
What are the differential diagnosis for mania?
Mixed affective state Scizoaffective disorder Schizophrenia Cyclothymia ADHD Drugs and alcohol
Stroke, MS, Tumour, epilepsy, AIDS, neurosyphilis, endocrine, Cushing’s, hyperthyroidism, SLE
How can you measure mania?
SCID
SCAN
Young mania rating scale
How do you treat mania?
Antipsychotics- Olanzapine, risperidone, Quetiapine
Mood Stabilisers- sodum valporate, lamotrigene, carbamazepine
Lithium
What are the various classes of bipolar affective disorders?
BAD currently hypomanic BAD currently manci without psychosis BAD current manic with psychosis BAD current mild/mod depression BAD current severe depression without psychosis BAD current severe depression with psychosis Bad current episode mixed Other bipolar affective disorder Bipolar affective disorder, unspecified
How do you define bipolar affective disorder?
Bipolar affective disorder consists of 2 or more repeated episodes of depression and mania/hypomania
What are the differentials for bipolar disorder?
No mania or hypomania- recurrent depression
No depression- hypomania or bipolar disorder
Describe the epidemiology of bipolar disorder?
Early onset 15-19 years old
No differential prevalence according to income, occupation, educational status or sex
Prevalence consistently increased in 1st relatives
No difference in rates
What is the typical outcome of Bipolar disorder?
Typical manic episodes last 1-3 months 60% fail to recover at 10 weeks 5% fail to recover 90%have further episodes 1/3 have poor outcome 10% die by suicide
