Bipolar and Related Disorders

Question 1

Bipolar is placed between ______ & _______ as a ______ in terms of symptomology, family history, and genetics.

Answer 1

1. SZ
2. depressive disorders
3. bridge

Question 2

Kay Redfield Jamison states that people with bipolar disease can be _____ ________.

Answer 2

high functioning

Question 3

BD patients will experience shame after an episode because of what?

Answer 3

they gain insight on what they did during an episode

Question 4

BD patients experiencing mania will want to ______ the episode? How do they do this?

Answer 4

extend; with substance use
ex: cocaine

Question 5

When is it best to work with a BD1 patient?

Answer 5

When they are at baseline/euthymia

Question 6

What can precede or follow a manic episode?

Answer 6

hypomania or major depressive episode

Question 7

What is criteria A for BD1?

Answer 7

for one week one must experience elevated, expansive, or irritable mood

they are persistently goal-directed full of energy

Question 8

What is needed for criteria B in BD1?
think # of sxs

Answer 8

must have 3 or more symptoms
*4 or more if the mood is irritable

Question 9

What are the 7 symptoms of BD1?

Answer 9

1. inflated self-esteem; tangible grandiosity
2. less need for sleep
3. more talkative than usual or have a pressure to keep talking
4. racing ideas/thoughts
5. easily distracted by unimportant stimuli
6. increase in goal-directed activity
7. excessive involvement in activity that may have really bad consequences

Question 10

T/F people are commonly arrested during BD1?

Answer 10

True

Question 11

What is needed for criteria C?

Answer 11

the mood disturbance must be severe enough to caused MARKED IMPAIRMENT in social or occupational functioning
OR
there is a need to be hospitalized to prevent harm to self or to others
OR there are psychotic features

Question 12

What automatically qualifies as a manic episode over the duration of the 1 week requirement of sxs?

Answer 12

being hospitalized

Question 13

What is different in the hypomanic criteria from manic criteria?

Answer 13

A. duration 4 days
B. No differences
C. there is a change from prior functioning but it is not markedly impairment
D. mood and change is observable by others
E. no marked impairment, no hospitalization, no psychotic features

Question 14

What is criteria A for BD2?
think duration

Answer 14

must have a hypomanic episode for 4 or more days & and current or past major depressive episode of 2 weeks or longer

Question 15

What is great chronicity?
Which BD spends less time in euthymia?

Answer 15

GC = less time at baseline & episodes last longer
BD2

Question 16

What are BD2’s distinct episode features?
think duration phase & impulsivity

Answer 16

longer depressive phases
common impulsivity = suicide attempts & substance use

Question 17

What is criteria A for cyclothymia?
think duration sxs

Answer 17

must experience hypomania & depressive symptoms for at least 2 years for adults/1 year for youth

Question 18

What is criteria B for cyclothymia?
duration requirements

Answer 18

during the 2 yr period at least 1/2 the time must experience the symptoms and remissions periods cannot be longer than 2 months

Question 19

What is criteria C for cyclothymia?

Answer 19

never had an episode of M or D

Question 20

Name 2 BD related disorders and their causes.

Answer 20

1. Substance/Medication-Induced Bipolar and Related Disorder
   -intoxication/withdrawl
   -steroids
   -cocaine
   -methamphetamine
   -amphetamine
2. Bipolar and Related Disorder Due to Another Medical Condition
   -TBI
   -stroke
   -tumor
   -multiple sclerosis
   -Cushing’s disease

Question 21

What is the duration prevalence of cycling?

Answer 21

35% go through 1 cycle in 5 years
1% go through 1 cycle every 3 months

Question 22

What is rapid cycling?

Answer 22

experiencing 4 cycles (episodes) in 1 year
episodes have a max of 2 month remissions or they switch to opposite polarity

Question 23

___% of BD patients abuse ____.

Answer 23

50%; illicit substances

Question 24

What is the indirect and direct pathway that light regulates people?

Answer 24

1. indirect: modulates circadian rhythms
2. direct: can affect mood without disrupting circadian rhythms

Question 25

What is the epidemiology for BD1, BD2, & cyclothymia?

Answer 25

BD1: equal between genders; onset at 18

BD2: higher in males; onset at mid 20s

Cycl.: equal between genders; onset at adolescence/early adulthood

Question 26

What is the gender difference in epidemiology?

Answer 26

females experience mixed episodes, more depressive symptoms, and more comorbidity of alcohol use

Question 27

BD carries a lifetime ___ times higher risk of suicide in comparison to the general population.

Answer 27

15

Question 28

BD accounts for ___% of all completed suicides.

Answer 28

25

Question 29

What are the commonalities and differences of BD & BPD?

Answer 29

impulsivity and mood liability

BPD doesn’t had overlapping neurological pathways
stronger genetic contributions in BD
sexual abuse and parasuicidal behaviors are more comorbid with BPD

Question 30

What is borderline personality disorder?

Answer 30

a pervasive pattern of instability of interpersonal relationships, self-image, and markedly impulsivity