Psychiatry - Bipolar disorder Flashcards
1
Q
What is Bipolar disorder?
A
Major depression alongside at least one:
- Manic (bipolar I) episode;
- Hypomanic (bipolar II) episode.
Patients eventually suffer from depressive symptoms:
- Viewed as cyclical interchanging - high/Low mood;
- Patients functioning normally between episodes.
- Men and women equally affected
2
Q
Bipolar Disorder?
Causes?
A
Genetic:
- Family history of bipolar disorder
- Involvement of chromosomes 6q & 8q21
Neurohormonal:
- Monoamine hypothesis - (predicts that the underlying pathophysiologic basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system)
Neuroanatomical:
- Inc size of lateral ventricles
- Abnormal HPA axis
Psychosocial:
- Adverse life events
- Negative childhood experiences
- PTSD
3
Q
Bipolar Disorder?
Types?
A
Bipolar I:
- At least one manic episode lasting > 1 week
- Usually coupled with periods of depression
- Some patients may only have manic episodes
Bipolar II:
- >1 episode of severe depression,
- but only coupled with hypomania
Rapid cycling:
- >4 mood swings in one year
Cyclothymia:
- Mood swings not as severe as bipolar disorder
- Cyclical and may last for longer periods
4
Q
Bipolar Disorder?
Treatments?
A
Treatment:
- Depends on if urgent or non urgent
- Follow local guidelines
Psychological therapy:
- CBT
- Family focused therapy
- Liaise with social services
Pharma therapy:
- Anti-psychotics
- Mood stabilizers
- Anti-epileptics
5
Q
Bipolar Disorder?
Symptoms?
A
Those of depression
Those of Mania must be present for one week- DIG FAST:
- D - Distractibility
- I - Irresponsible behaviour
- G - Grandiosity, delusions of power/wealth
- F - Flight of ideas
- A - Activity increases
- S - Sleep decreases
- T - Talkativeness
6
Q
Bipolar Disorder?
Investigations?
A
Rule out other causes of psychosis:
- Such as drug induced
- Organic mood disorders
- Perform risk assessment
Tests:
- Bloods
- ECG (QTc prolongation)
- Investigations for depression
