Bipolar D/O- 14A

Question 1

Diagnostic criteria for Bipolar I disorder

Answer 1

• no not need history of depressive episode
• must have history of manic episode
• with marked impairment
• sx lasting at least 1 week OR hospitalization

Question 2

Diagnostic criteria for Bipolar II disorder

Answer 2

-history of hypomanic episode AND depressive episode

Question 3

Diagnostic criteria for Cyclothymia

Answer 3

• mood cycling disorder over 2 years
• NO HISTORY OF MANIC EPISODE
• hypomania x 2yrs AND depression x 2 yrs

Question 4

Epidemiology of Bipolar I D/O

Answer 4

• prevalence of 1%
• Male=Female
• 50% make a suicide attempt
• 15% complete suicide
• 50% develop associated psychosis

Question 5

Diagnostic criteria for hypomania

Answer 5

• symptoms present for 4 d
• relatively minor impairment and DOES NOT require hospitalization
• changes in behavior /mood observable by others

Question 6

Specifiers for mania, hypomania, depression episodes

Answer 6

• mixed
• rapid cycling
• peripartum onset
• seasonal pattern
• anxious distress

Question 7

Specifiers for mania and depression

Answer 7

• mood congruent psychotic symptoms
• mood incongruent psychotic symptoms
• catatonia

Question 8

Diagnostic criteria for mixed features of manic or hypomanic episode

Answer 8

• mania/hypomania + 3 characteristics

- elevated suicide risk

Question 9

Definition of rapid cycling

Answer 9

• at least 4 mood episodes in 1 year
• F>M
• Valproate indicated

Question 10

Ultra-rapid cycling

Answer 10

-multiple episodes in 1 month

Question 11

Ultra-ultra rapid cycling

Answer 11

• Ultridian
• multiple cycles in 1 day
• look for drug, medication, or medical cause

Question 12

Criteria and epidemiology of peripartum onset

Answer 12

• onset of mood symptoms during pregnancy or up to 4 weeks after delivery
• 3-6% of women experience depression
• psychosis in 1/500 women
• risk: infanticide with CAH to kill neonate or delusion that neonate is possessed

Question 13

Criteria for Catatonia

Answer 13

-3 or more of the following
posturing
mannerisms
sterotypy
agitation
grimacing
echolalia
echopraxia

Question 14

Name medical causes of mania

Answer 14

-CVA (right sided)
-Seizure disorder (right temporal)
-Subdural hematoma
-TBI (9% develop mania)
-HIV
typically due to hypofrontal symptoms

Question 15

Describe orbitofrontal syndrome mimicking mania

Answer 15

• disinhibited behaviors
• labile mood
• psychosis/delusion

Question 16

Drugs/treatments associated with mania

Answer 16

• anabolic/corticsteroids
• sympathomimetics- eg pseudoephedrine
• Dopamine Agonists
• Isoniazid
• Antibotics- Clarythromycin