Bipolar Disorder

Question 1

Manic symptoms

Answer 1

DIGFAST

Distractibility
Increase in pleasurable activity
Grandiose
Flight of ideas
Activity increased
Sleep decreased need
Talkative (pressured speech)

Question 2

What is a manic episode

Answer 2

Abnormal, persistently elevated, expansive/irritable mood >1week/hospitalisation

Question 3

What is a hypomanic episode

Answer 3

Abnormal, persistently elevated, expansive/irritable mood >/=4 days which is clearly different from normal mood
>no psychotic symptoms
>no hospitalisation
>slight changes in mood and function = uncharacteristic and observable by others
>manic symptoms to lesser degree

Question 4

What is cyclothymic disorder?

Answer 4

Hypomanic and depressive symptoms but doesn’t meet the criteria for hypomanic or major depressive episode

Question 5

Specifiers for Bipolar Disorder

Answer 5

Catatonia -
Anxious distress -
Psychotic features - mood congruent/incongruent
Atypical presentation - hypersomnolence, weight gain
Melancholic features - dismay, despair, no appetite
Mixed features - manic and depressed symptoms
Peripartum onset

Question 6

Lifetime pattern of bipolar disorders

Answer 6

Rapid cycling = >/=4 manic episodes/year
Seasonal pattern = winter
Partial remission = it all symptoms gone OR all symptoms gone but not long enough
Remission = no sx for >2months

Question 7

When do you hospitalise a bipolar patient?

Answer 7

Suicidal
Relapse and no access to food/shelter/support system
Rapidly progressive symptoms
Psychosis
Manic, depressive, mixed episodes
Involuntary/voluntary admission