W15_06 bipolar disorder

Question 1

note: decreased need for sleep is a hallmark symptom of mania

Answer 1

ok

Question 2

what are the symptoms of mania? GSTPAID

Answer 2

grandiosity;
sleep (need less);
talkative;
painful (consequences);
activity (increased goal-directed activity)/psychomotor agitation;
ideas (flight of);
distractibility

Question 3

how long do manic symptoms have to last to fulfill mania criteria?

Answer 3

1 week

Question 4

what’s the difference between hypomania and mania

Answer 4

4 days;
criteria for mania are the same;
hypomania episode is not severe enough to cause impairment in social/occupational functioning

Question 5

what’s the difference between bipolar I and bipolar II?

Answer 5

if there’s 1 manic episode, then patient is bipolar I

Question 6

prevalence of bipolar disorder?

Answer 6

bipolar I: 1%;
bipolar II: 1.1%

Question 7

note:

Answer 7

bipolar patients spend more time being depressed than being manic. About half of the time, they are asymptomatic

Question 8

is there a genetic component of bipolar disorder?

Answer 8

yes

Question 9

note: there are cognitive deficits associated with patients with bipolar disorder

Answer 9

ok

Question 10

note: bipolar disorder is often misdiagnosed

Answer 10

unipolar depression, anxiety disorders, schizophrenia, personality disorder, alcohol abuse/dependence

Question 11

what’s the treatment for bipolar disorder?

Answer 11

pharmacotherapy;
psychosocial therapy

Question 12

what does IPSRT stand for?

Answer 12

interpersonal social rhythm therapy

Question 13

what’s the difference between IPSRT vs IPT?

Answer 13

IPSRT for bipolar;
IPT for depression

Question 14

note: good to do investigations before starting psychiatric treatment to get a baseline of their organ functions

Answer 14

ok

Question 15

what’s CANMAT?

Answer 15

canadian network for mood and anxiety treatments

Question 16

first line therapies for bipolar 1 depression?

Answer 16

lithium, lamotrigene, quetiapine (antipsychotics are used to treat seizures, mood problems), and more

Question 17

first line therapies for bipolar 1 mania?

Answer 17

lithium, divalproex, risperidone, and more

Question 18

first line therapies for bipolar 1 maintenance?

Answer 18

lithium, lamotrigine, divalproex, and more

Question 19

what does lithium do?

Answer 19

gold standard that treats all three phases of bipolar;
small therapeutic index with lots of side effects. Renally cleared, so take into account any water pills

Question 20

what’s divalproex?

Answer 20

anticonvulsant used in mania and maintenance phases of bipolar

Question 21

what’s lamotrigine?

Answer 21

anticonvulsant used in depression phase of bipolar;
risk of steven-johnson syndrome

Question 22

note: atypical antipsychotics show some evidence for treating all three phases of bipolar disorder

Answer 22

ok