7 Bipolar

Question 1

What are the 5 different stages of moods?

Answer 1

Mania, hypomania, euthymia, dysthymia, depression

Question 2

What is the mild form of bipolar and what two moods is it made up of?

Answer 2

Cyclothymic - hypomania and dysthymia

Question 3

What is disruptive mood dysregulation?

Answer 3

A new diagnosis for children as BD was being over diagnosed

Question 4

What 4 symptoms might you have if you have mania?

Answer 4

Irritable mood, abnormal goal directed behaviour / increased self-esteem, decreased need for sleep, excessive talking, flight of idea’s

Question 5

What is hypomania?

Answer 5

It is less severe than mania / no marked impairment

Question 6

What 4 symptoms might you have if you have major depression?

Answer 6

Low mood, anhedonia / weight change, sleep disturbances, psychomotor agitation, fatigue, guilt, suicidal, dysfunction

Question 7

What are the two types of depression?

Answer 7

Bipolar and monopolar

Question 8

What happens during episode free periods?

Answer 8

Social functioning and cognition decreases

Question 9

What is bipolar 1?

Answer 9

Having episodes of major depression and mania

Question 10

What is bipolar 2?

Answer 10

Having major depression and hypomania / being impulsive

Question 11

What are the gender differences in bipolar?

Answer 11

Women: more depressed, thyroid dysfunction, atypical or reverse vegetative, postpartum, comorbidity

Question 12

What are the gender differences in bipolar comorbidity?

Answer 12

Women: more comorbid with anxiety / Men: more comorbid with substance abuse

Question 13

What is the Switch?

Answer 13

The transition from one mood, to one of opposite polarity / usually depression to mania

Question 14

What triggers cause the Switch?

Answer 14

Stress, sleep deprivation, antidepressants, ECT, substances

Question 15

List three environmental factors which might cause bipolar?

Answer 15

Childhood adversity, chronic stress, trauma, mood instability, sleep disturbances (irregular, reduction, time zones)

Question 16

What REM patterns may trigger bipolar?

Answer 16

Low REM latency and high REM density

Question 17

What % heritability is bipolar?

Answer 17

85%

Question 18

What two genes may cause bipolar?

Answer 18

CLOCK and PER3

Question 19

What does and doesn’t neuroimaging of bipolar patients brains show?

Answer 19

Does show hypoactive OFC / risk / impulsivity

Doesn’t show if somehow has bipolar

Question 20

How do bipolar patients react in the pre-pulse inhibition tasks?

Answer 20

They are just as startled the second time / do not block important information

Question 21

What differences do bipolar patients have at the HPA axis?

Answer 21

Decreased hippocampal and amygdala volume

Question 22

What does stress increase and what effect does this have?

Answer 22

Increases glucocorticoids, leading o neuronal loss

Question 23

What are the three main therapeutic goals in BD?

Answer 23

Treat symptoms, prevent relapse, reinstate

Question 24

What are the two types of drugs used in treating BD?

Answer 24

Adjuncts and mood stabilizers

Question 25

Give an example of an adjunct drug?

Answer 25

Modafinil, thyroid

Question 26

Give an example of a mood stabiliser drug?

Answer 26

Lithium, anti epileptics, atypical antipsychotics

Question 27

What % effectiveness is lithium?

Answer 27

60-80%

Question 28

How does lithium work to treat BD?

Answer 28

Alters neuronal excitability in the hippocampus - EPSP's

Question 29

What two parts of BD is lithium most effective in treating?

Answer 29

Manic episodes and suicide

Question 30

What percentage of BD patients relapse on lithium?

Answer 30

< 30%

Question 31

A downside of lithium is that is has a N_ T_ W_?

Answer 31

Narrow therapeutic window

Question 32

Name three drugs that we learnt about, which treat BD?

Answer 32

Lithium, valporic acid, carbamazepine, lamotrigine, ketamine, atypical anti-psychotics

Question 33

How does valporic acid work in treating BD?

Answer 33

Increases GABA or inhibits sodium

Question 34

How does carbamazepine work in treating BD?

Answer 34

Block voltage sensitive sodium channels

Question 35

How does lamotrigine work in treating BD?

Answer 35

Acts on sodium channels / an anticonvulsant

Question 36

Which drug used in treating BD has the least side effects / has some positive side effects? What are they?

Answer 36

Lamotrigine: increases cognitive functioning / safe for fetus'

Question 37

What two drugs that are used for treating BD, do we not know how they work?

Answer 37

Ketamine and atypical antipsychotics

Question 38

What % of BD patients stop drug treatment?

Answer 38

50%

Question 39

What happens when BD patients stop drug treatment?

Answer 39

Symptoms worsen / increase in suicide rates

Question 40

What is an alternative to drug therapy is BD treatment?

Answer 40

Psychotherapy

Question 41

How does psychotherapy work for BD patients?

Answer 41

Psychoeducation: what it is, what happens, how to deal with, how to prevent triggers?