bi-polar

Question 1

Manic episode symptom

Answer 1

Marked increase in activity level (work, social, sexual) Unusual talkativeness, rapid speech
Flight of ideas or racing thoughts
Less than the usual amount of sleep needed
Inflated self-esteem & believe have special talents, powers, and abilities
Distractibility, attention easily diverted
Excessive involvement in pleasurable activities that are likely to have undesirable consequences (e.g., reckless spending)

Question 2

Major depressive episodes

Answer 2

High suicide risk
• Associated problems • Domestic violence
• Divorce
• Truancy
• Occupational failure
• Substance abuse
• Episodic antisocial behaviour

Question 3

Prevalence

Answer 3

Lifetime prevalence: 0.4–2.2% ~3 people in this class
No gender difference
3:1 depressed : manic days

Question 4

course

Answer 4

Average age of onset 18-22
Recurrent
> than 50% of cases have 4+ episodes

Question 5

Etiology: Bio

Answer 5

Genes
1o relatives at risk
Unipolar > bipolar
Twin studies
MZ twins 85% DZ twins 14%

Question 6

NTs

NE, DA, 5-HT (all involved in mood states)

Answer 6

down - NE & DA>depression

up NE & DA>mania

Question 7

etiology: psychosocial

Answer 7

Pessimistic attributional style
Personality
• Neuroticism
• High levels of achievement striving
Stressful life events (esp. dependent) Low social support

Question 8

Treatment: Bio

Answer 8

Pharmacotherapy
• Mood stabilizers (e.g., Lithium, anticonvulsants) • Antipsychotics
Other Bio • TMS
• ECT

Question 9

lithium

Answer 9

Lithium
Relapse rate = 34% with lithium
(vs. 81% with placebo) over 1 year
Not effective over long haul (36% over 5 years)
Prognosis
Good: Family hx of bipolar illness
Poor: Rapid cycling, multiple prior episodes, substance abuse

Question 10

Treatment: Psycho

Answer 10

CBT
• Cognitive restructuring
• Behavioural activation
Mindfulness based cognitive therapy (MBCT)
• Acceptance of thoughts, emotions
Interpersonal and social rhythm therapy
• Interpersonal interactions can influence daily rhythms
Family & marital therapy
• Reduce criticism, hostility (expressed emotion; EE)