DSM Criteria

Question 1

What is Bipolar I disorder?

Answer 1

Presence of at least one full fledged (disrupting normal social and occupational function) manic episode, and usually depressive episodes.

Question 2

What is Bipolar II?

Answer 2

Presence of major depressive episodes with at least one hypomanic episode, but no full-fledged manic episodes.

Question 3

What is a manic episode?

Answer 3

> 1w of a persistently elevated expansive or irritable mood and persistently increased goal-directed activity or energy plus >3 additional symptoms

Question 4

What are the additional symptoms characterising a manic episode?

Answer 4

D = Distractibility and easy frustration
I = Irresponsibility and erratic uninhibited behavior
G = Grandiosity

F = Flight of ideas
A = Activity increased with weight loss and increased libido
S = Sleep is decreased
T = Talkativeness

Question 5

What is manic psychosis?

Answer 5

• Psychotic symptoms (diff to distinguish from schizophrenia)
• Extreme grandiose or persecutory delusions (e.g. being Jesus)
• Sometimes hallucinations
• Marked activity increase
• Mood very labile
• May enter delirium (delirious mania)
• labile
• often very angry, intrusive, uncooperative
• no sleep
• very talkative, flight of ideas

Question 6

What is hypomania?

Answer 6

-Less extreme variant
-Episode last >2-4d
-Behaviour distinctly diff from patient’s usual non depressed self
-includes >3 or additional symptoms of mania
Mood brightens, decreased sleep requirement, psychomotor activity increases, pressured speech

Question 7

What is depressive episode?

Answer 7

>5 of the following in 2w period with one being depressed mood:
C GASP DIE:
-Concentration impaired
- Guilt / worthlessness
- Appetite or weight change
- Sleep disturbance
-Psychomotor retardation
- Death or suicide
- Interest (diminished) 
-Energy (loss)

Question 8

How is BPAD diagnosed?

Answer 8

• Clinical criteria (DSM) ==> identify Sx of mania/hypomania + Hx remission-relapse
• T4 and TSH (r/o hyperthyroidism)
• Exclude stimulant drug abuse clinically or urine test

Question 9

Diagnostic symptoms of GAD?

Answer 9

WATCHERS

• Worry
• Anxiety
• Tension in muscles
• Concentration difficulty
• Hyperarousal (or irritability)
• Energy loss
• Restlessness
• Sleep disturbance

Question 10

Symptoms of PTSD?

Answer 10

TRAUMA

• Traumatic event
• Re-experience
• Avoidance
• Unable to function
• Month or more of symptoms
• Arousal increased

Question 11

Antidepressant discontinuation features?

Answer 11

FINISH

• Flu-like symptoms
• Insomnia
• Nausea
• Imbalance
• Sensory disturbances
• Hyperarousal (anxiety/agitation)

Question 12

Neuroleptic malignant syndrome features?

Answer 12

NMS features = FEVER

• Fever
• Encephalopathy
• Vital sign instability
• Elevated WBC/CPK
• Rigidity

+WBC: white blood cell count
+ CPK: creatine phosphokinase

Question 13

Substance abuse features?

Answer 13

WILD

• Work, school, or home role obligation failures
• Interpersonal or social consequences
• Legal problems
• Dangerous use

Question 14

What are the features of substance dependence?

Answer 14

Substance dependence = ADDICTeD

• Activities are given up or reduced
• Dependence, physical: tolerance
• Dependence, physical: withdrawal
• Intrapersonal (Internal) consequences, physical or psychological
• Can’t cut down or control use
• Time-consuming
• Duration or amount of use is greater than intended

Question 15

Delirium causes menmonic?

Answer 15

I WATCH DEATH

• Infection
• Withdrawal
• Acute metabolic
• Trauma
• CNS pathology
• Hypoxia
• Deficiencies
• Endocrinopathies
• Acute vascular
• Toxins or drugs
• Heavy metals