2 - PSY - Mania and Bipolar Flashcards Preview

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Flashcards in 2 - PSY - Mania and Bipolar Deck (19):
1

Sx of hypomania

mild elevation/instability of mood
^mood
overspending, risk taking
^sociability, overfamiliarity
distractibility
^libido
decreased need for sleep

2

Sx of mania

^mood, expansive, irritable
^activity
recklessness
disinhibition
^distractibility
^^libido
sleep impaired/absent
grandiosity
flight of ideas

3

Mania with psychotic Sx - whats added

delusions - often mood congruent - eg inflated self esteem --> grandiose beliefs

hallucinations occur less frequently

4

Diagnosing bipolar ---
1 manic episode =
2 manic episodes =
1 mania + 1 depressive episode =
2 episodes depression =

- acute mania
- bipolar affective disorder
- bipolar affective disorder
- recurrent depressive disorder

5

define dysthymia

chronically low mood, no episode justifies a diagnosis of depression

6

define cyclothymia

persistent instability of mood - no elevation/low period reaches threshold for diagnosis of mania/depression

7

define double depression

episode of depression in someone with a dysthymia history

8

organic differentials in bipolar affective disorder

substance misuse (incl steroids)
hyperthyroid (v severe)
SOL (frontal lobe)
metabolic disorders
epilepsy

9

BAD epidemiology
lifetime risk, M:F, onset?

lifetime risk is 1%
male = female
onset generally late teenage to early twenties

10

aetiology of BAD

genetics, life events, substance misuse

11

what can cause a relapse???

not taking meds
life events, social stressors
circadian rhythm disrupted
substances
childbirth
natural course of illness

12

Biological Tx of acute mania

consider benzos for disturbance
offer AP
stop any antidepressants
consider lithium/valproate

13

Social Tx of acute mania

maintain carer relationships
?inpatient admission
calming, low stimulus environment
advise not to make serious decisions whilst unwell
consider use of MHA

14

Bio Tx of bipolar depression

antidepressant WITH anti-manic agent
consider mood stabiliser/optimise dose
consider 2nd gen/atypical AP

15

Psych Tx of bipolar depression

CBT if mild/mod episode
psychoeducation

16

Social Tx of bipolar depression

?inpatient admission if risk indicates
support with regard to education, training, employment
work around social inclusion
carer support

17

Preventing relapse in BAD - bio

lithium - valpraote/olanzapine if intolerable (can add valproate to lithium)
never prescribe AD without mood stabiliser
consider AP in Wo of CBA

18

Preventing relapse in BAD - psych

Psychoeducation
family intervention
long term CBT

19

Preventing relapse in BAD - social

CPN and OP's to monitor pt
housing, benefits, education, training, employment support
work around social inclusion
carer support

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