Bipolar disorder

Question 1

Depressive state

Answer 1

Depressed mood, loss of interest or pleasure in most activities, weight/apetite changes, sleep changes, tiredness, fatigue, low energy

Question 2

Hypomania

Answer 2

Abnormal, persistent elevated, expansive, or irritable mood and increased goal-directed activity or energy for at least 4 days

May have some: higher energy and better mood, marked feelings of well-being, increased sexual energy, decreased need for sleep

Question 3

Manic state

Answer 3

Abnormal, persistent elevated, expansive, or irritable mood and increased goal-directed activity or energy for at least a week

3 of: inflated self-esteem or grandiosity, more talkative, distractibility, flight of ideas, increased goal-directed activity or psychomotor agitation

Causes impairment in social work or life. Necessitates hospitalization or includes psychosis

Question 4

BD I

Answer 4

Larger swings on both depression and manic episodes

Question 5

BD II

Answer 5

Large swings on depression, but never crosses into mania. Stays in hypomania

Question 6

When can BD be diagnosed

Answer 6

Only diagnosable if persistent swings between mania and depression are persistent and in quick succession. Otherwise the individual may be dealing with different psychiatric disorder

Question 7

Reward hypersensitivity model

Answer 7

Goal attainment leads to excessive reward states

Goal non-attainment can lead to excessive reward deactivation

Based on if they acheive their goal, they may go into (hypo)mania or depression

Question 8

Evidence for reward hypersensitvity model

Answer 8

at neutral state, individuals have excessive activity in frontal-striatal reward-related areas

makes more risky choices

Question 9

Prodromal features of (hypo)mania and depressive episodes

Answer 9

(hypo)mania: excessive goal setting and increased success expectancies

depressive episodes: decresaed motivation and goal setting and low self-confidence

Question 10

Functional changes in brain with BD

Answer 10

Increased responsiveness in limbic and paralimbic areas: amygdala, ventral PFC, ventral anterior cingulate cortex

Decreased responsiveness in areas associated with cognitive control: dorsal anterior cingulate cortex, dorsal medial PFC, dorsal lateral PFC

Question 11

Structural changes

Answer 11

Reduction in gray matter

Driven by time spent in manic episodes (neuroinflammation, stress hormones)

Question 12

BD pharmaceutical treatments

Answer 12

Mood stabilizers (lithium alone or combined with atypical antipsychotics)

atypical antipsychotics

Antidepressants used in conjunction with others