Bipolar and Related Disorders Flashcards
Major Depressive Episode (MDE) symptoms
2-week period; at least 5 symptoms occur most of the day, nearly every day:
- depressed mood
- anhedonia or diminished pleasure/interest in activities previously pleasurable
- significant weight loss/gain or decreased/increased appetite
- insomnia or hypersomnia
- agitation/psychomotor retardation
- feeling of being slowed down
- fatigue/loss of energy
- guilt/feelings of worthlessness
- indecisiveness, difficulty concentrating
- thoughts of death or suicidal ideation without specific plan
Manic Episode symptoms
period of increased energy and elevated mood/irritability that lasts at least 7 days; at least 3 symptoms:
- grandiosity
- decreased need for sleep
- increased talkativeness
- racing thoughts
- distractibility
- increased activity
- excessive pleasure-seeking behaviors with high likelihood of negative consequences
Hypomanic Episode symptoms
4 consecutive days of expansive, elevated, or irritable mood and increased activity/energy; 3 or more of following symptoms:
- increased self-esteem
- reduced need for sleep
- more talkative than usual
- racing thoughts or flight of ideas
- being easily distracted
- increase in goal-directed behavior or psychomotor agitation
- excessive involvement in activities that may result in painful consequences
Bipolar I & Bipolar II Disorders specifiers
- with anxious distress
- with mixed features
- with rapid cycling
- with melancholic features
- with atypical features
- with mood congruent psychotic features
- with mood incongruent psychotic features
- with catatonia
- with peripartum onset
- with seasonal pattern
Bipolar I Disorder symptoms
at least one manic episode that lasts min. of 7 days and includes increased goal-directed activity, energy and elevated & expansive mood or irritability most of the day for most days
Bipolar I Disorder assessment
PHQ-9: 9-item self-report used to measure depressive symptoms and can determine if treatment has been effective and if patient is in remission
Bipolar I Disorder treatment
Medication management: mood stabilisers
Psychosocial treatments - adjuncts:
- interpersonal & social rhythm therapy: routine & consistency
- CBT: improve adherence to medication
- MBCT: improve emotional processing & reduce anxiety
- DBT
- family-focused therapy
Bipolar II Disorder symptoms
at least one hypomanic & one major depressive episode, without any history of manic episode
- symptoms of depression cause functional impairment, but symptoms of hypomania do not
Bipolar II Disorder treatment
medication management, psychosocial therapy or combination of both
- CBT: reduce self-focused thinking & provide alternative to rumination
- psychoeducation
- family-focused therapy: increase life satisfaction & functioning
- interpersonal & social rhythm therapy: regulate daily routines and recognise link between routines & emotions
Cyclothymic Disorder symptoms
- symptoms present half the time over 2-year period; criteria for mania/MDD not met
- extreme mood instability & reactivity
- sleep disturbances and disrupt daily circadian & social rhythms
Cyclothymic Disorder treatment
- interpersonal & social rhythm therapy (IPSRT)
- family-focused therapy & CBT that incorporates circadian mood regulation
- CBT: reduce anxiety
- cognitive therapy aimed at mindfulness
Substance/Medication-Induced Bipolar and Related Disorders specifiers
- with onset during intoxication
- with onset during withdrawal
Bipolar and related disorder due to another medical condition specifiers
- with manic features
- with manic- or hypomanic-like episode
- with mixed features
