Bipolar Mania and Bipolar Depression Flashcards
What are 4 categories of symptoms associated with bipolar disorder with examples?
Manic Mood and Behavior Dysphoric or Negative
Euphoria Grandiosity Pressured speech Impulsivity Excessive libido Recklessness Social intrusiveness Diminished need for sleep
Psychotic Symptoms
Delusions
Hallucinations
Dysphoric or Negative Mood and Behavior Depression Anxiety Irritability Hostility Violence suicide
Thought /cogniiveDisorder Racing thoughts Distractibility Flight of ideas Inattentiveness
What are some disorders that bipolar individuals are commonly diagnosed with in order from most common to least common? How long does is it usually take for bipolar invividuals to be correctly diagnosed?
Depression, anxiety. schizophrenia, borderline/antisocial, alcohol/substance abuse, schizoaffective.
41% of those diagnosed with BP go 10 years before that happens.
What are mixed states?
What is Mixed Mania Dysphoric Mania Depressive Mixed states? Based on age, who is most like to present with mixed states?
Manic and Depressive symptoms at same time. Younger people much more likely to pressent that way than older.
Mixed Mania -Full mania/full MDE at same time..
Dysphoric Mania-Full Mania/2+ MDE symptoms
Depressive Mixed states-2+mania symptoms/Full MDE
What is unique about the epidemiology of rapid cycling bipolar disorder? Explain why this possibly might be the case?
Rapid-cycling 3:1(F:M); higher if >12 episodes/year
Possibly due to:
§ Higher rates of hypothyroidism (women > men)
§ Increased antidepressant use
§ Hormonal effects
What is the prevalence of BPD? Age of onset? Suicide rate? Correct diagnosis rate? Unipolar depression diagnosis rate?
Nationwide survey evaluated prevalence using mood disorder questionnaire
(MDQ)
Prevalence of 3.7% vs. previously accepted 1%
Onset highest in 18 - 24 age range
1 in 5 are diagnosed correctly
1 in 3 are initially diagnosed with unipolar
major depression
Suicide completion rate in bipolar as high as 10 - 15%
Minorities may be overdiagnosed as schizophrenic1
What are 5 medical comorbidities associated with BPD? 6 Psychiatric?
Diabetes mellitus, pain disorders, migraine, CV, obesity
Personality disorders, ADHD, substance abuse, impulse control, anxiety disorders, eating disorders
What is the mortality rate like for those that are treated/untreated? What is the most common cause?
Higher for those untreated of most everything such as CV, stroke, cancer, accident, etc. but especially from suicide.
When are the peak suicide time?
The several studies that have appeared since this figure was constructed continue to show the
main peak in the spring (may) and a smaller peak in the fall* (october)
What are some structural changes that occur in the brain with BPD progression (multiple episodes)?
Prefrontal Cortex ↓ L inf with ↑ illness duration
↓ gray matter volume with ↑ age
Striatum
No difference in putamen between first and multi-episode patients3
Cerebellum
↓ cerebellar vermis volume in multi- vs first episode patients
Amygdala
↑ amygdala volume with ↑ age in young patients
Ventricles
↑ ventricular volume in multi- vs first episode patients
↑ ventricular volume with ↑ number of manic episodes
↑ ventricular volume with ↑ number of affective episodes
What are some cues that can tell you that what looks like unipolar depression might be bipolar depression?
Early age of onset (5-29 years)
Postpartum onset
Hyperphagia and Hypersomnia (reversed
vegetative Symptoms)
Psychomotor slowing
Severe anhedonia
Depression with catatonic and/or psychotic features
Family history of bipolar illness or mood swings
History of AD- induced mania or hypomania
History of brief hypomania or mood swings
