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Flashcards in Bipolar Deck (21):
1

Bipolar Disorder DSM 5 criteria

1 manic episode
-elevated, expansive, or irritable mood present for at 1 WEEK
-3 symptoms (4 if mood is only irritable)
D-distractibility
I-irresponsibility
G-grandiosity
F-flight of ideas
A-activity increased/psychomotor agitation
S- sleep need decreased
T-Talkativeness or pressured speech

2

Breakdown of bipolar stages

40% depression
5% manic
45% euthymic

3

What is the risk of suicide?

15-20X higher risk !
highest risk

4

Bipolar 2

major depressive episode + hypomania

5

Hypomania

3 of manic symptoms
for 4 days
-not so severe to cause marked impairment in functioning or require hospitalization
-NO psychosis (if there was psychosis it would be bipolar 1)

6

Cyclothymic disorder

2 years of minimum mood cycling but never meet enough criteria for bipolar 1 or 2 or major depressive disorder

7

Bipolar Unspecified

never meet full criteria

8

Men Vs women bipolar

equal

9

Genetics of Bipolar

Twins-75-85%
DZ twins-15-20%
1 parent-10%
2 parents 50%

10

Higher socioeconomic or lower bipolar

higher

11

which has a higher chance of becoming psychotic, bipolar or unipolar depression?

bipolar

12

What brain structure is enlarged in bipolar patients?

ventricles and increased white matter hyperintensities

13

What are some hints that a person might be bipolar when presenting with depression

1. early onset (before 20)
2. psychotic depression
3. 1st episode is postpartum especially if psychotic
4. recurrent depression with more than 5 episodes
5. bipolar family history
6. seasonal mood disorder
7. atypical depression
8. hypomania associated with antidepressants
9. repeated loss of efficacy of antidepressants over time
10, trait mood liability, hyperthymic temperament
11. depression with mixed mood states

14

Suicidal ideation

I wish i were dead
the world would be a better place without me
-fleeting but can begin to persist on a daily basis
34% plan to attempt

15

Suicidal Intent

thoughts have moved to thinking how someone would commit
72% attempt to kill

16

Leading cause types of suicide

51% firearms
25% suffocation
17% poisoning

17

male suicide vs women

4:1 commit men
3:1 attempt female

18

Highest risk group for suicide?

1. vets
2. males
3. middle aged
4. elderly
5. caucasians
6. adolescents

19

Most serious risk factor listed first:

1. currently has a feasible plan
2. prior attempts
3. psychosis
4. high anxiety
5. impulsivity
6. presence of mental disorder
7. substance abuse
8. hopelessness
9. lack of support
10. family history of completed suicide
11. significant neg event in last 3 months
12. gun in the house

20

Are there low serotonin receptors and serotonin levels in CNS of suicides?

yes

21

Prevention of suicdie

Ask
Behavior incidents-details
Risk analysis
Remove means; make sure patient is safe