Mood instability (G12)

Question 1

Which of the following statements is FALSE?

a. Bipolar 1 affects men and women equally.
b. Bipolar 2 affects more men.
c. Bipolar 2 affects more women .

Answer 1

b. Bipolar 2 affects more men.

Question 2

a) define mood instability

b) Name six disorders in which mood instability can occur

Answer 2

a) Rapid oscillations of intense affect, with a difficulty in regulating these oscillations or their behavioral consequences
b) Depression, anxiety, PTSD, OCD, BPD, bipolar disorder

Question 3

Which of the following is NOT a recent development that can help the progress in defining and measuring mood instability?

a. Brain imaging
b. Momentary assessment
c. Remote sensors

Answer 3

a. Brain imaging

Question 4

Describe the steps of management in treating patients with bipolar disorder. Make sure to clarify the distinction between acute management and long-term management.

Answer 4

First step is to confirm the diagnosis of mania or hypomania and also to define patient’s mood state. Factors that could be analysed to confirm this are: medical/psychiatric comorbidities, previous/current treatments, response to treatment or willingness to be treated.

Primary goal of acute management: ensure safety of patient and people nearby. Achieve clinical and functional stabilisation with minimum adverse effects
Primary goal of long term management: prevent recurrence of episodes, ensure functionality while optimising treatment.

Acute management of bipolar for mania is mood stabilisers and antipsychotics. Acute management of bipolar for depressions is serotonin reuptake inhibitors

Long term management of bipolar: lithium for prevention of both manic and depressive episodes. Pharmacotherapy, mood stabilisers and tailored psychosocial interventions decrease risk of relapse. Psychoeducation, CBT and family focused therapy.