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Psychopathology PSYC 340 > Mood Disorders - Bipolar Disorders > Flashcards

Mood Disorders - Bipolar Disorders Flashcards

1
Q

DSM-5 criteria for bipolar I

A
  • at least one manic episode
  • hypomanic episodes often occur, but not necessarily
  • major depressive episode usually occurs, but not necessarily
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2
Q

DSM-5 criteria for bipolar 2

A
  • at lest one hypomanic episode
  • no history of manic episode
  • at least one major depressive episode
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3
Q

DSM-5 criteria for manic episode

A
  • at least 3 of these (change from baseline)
    1. inflated self-esteem or grandiosity
    2. decreased need for sleep
    3. talkative, pressured speech
    4. flight of ideas, racing thoughts
    5. distractible
    6. increase in goal-directed activity or psychomotor agitation
    7. excessive sensation-seeking/risky activity
    8. irritability (*4 if this is one of them)
  • present most of the day for at least 1 week
  • causes significant impairment in functioning or necessitates hospitalization
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4
Q

DSM-5 criteria for hypomanic episode

A
  • at least 3 of these (change from baseline)
    1. inflated self-esteem or grandiosity
    2. decreased need for sleep
    3. talkative, pressured speech
    4. flight of ideas, racing thoughts
    5. distractible
    6. increase in goal-directed activity or psychomotor agitation
    7. excessive sensation-seeking/risky activity
    8. irritability (*4 if this is one of them)
  • present most of the day for at least 4 days
  • symptoms do not cause marked impairment in social or occupational functioning
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5
Q

range of mood symptoms in bipolar disorders

A
  1. manic
  2. hypomanic
  3. normal
  4. dysthymic
  5. major depressioin
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6
Q

DSM-5 criteria for cyclothymic disorder

A
  • milder hypomanic symptoms and milder depressed mood
  • lasting at least 2 years
  • no history of hypomanic, manic, or major depressive episode
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7
Q

mixed features diagnosis

A
  • meets criteria for MDE and mania at least 1 week, nearly everyday
  • refer to graph in notebook
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8
Q

rapid cycling

A
  • 4+ mood episodes in given year
  • poorer long-term prognosis
  • about 1/3 with bipolar exhibit both mixed features and rapid cycling
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9
Q

evaluating mood symptoms//

A
  • diagnosis = complicated
  • brief depressive and hypomanic symptoms can occur in individuals without a mood disorder
  • depression and irritability occur both in depressive and bipolar disorders
  • people often fail to report hypomanic symptoms
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10
Q

prevalence of bipolar disorders: lifetime prevalence

A
  • bipolar 1 = 0.4-1%
  • bipolar 2 = 0.6-1.1%
  • cyclothymia = 0.4-1%
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11
Q

prevalence of bipolar disorders: peak age of onset

A
  • late adolescence
  • early adulthood
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12
Q

prevalence of bipolar disorders: gender differences

A
  • generally no sex difference for bipolar 1 and cyclothymia
  • mixed data for bipolar 2
  • rapid cycling and mixed features more common among women
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13
Q

prevalence of bipolar disorders: manic and hypomanic recurrence

A
  • 50% of cases have recurrence within 1 year
  • more than 50% of cases have 4 episodes
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14
Q

prevalence of bipolar disorders: comorbidity with SUD and anxiety

A
  • women: higher rates of comorbid eating disorders and anxiety
  • men: higher rates of comorbid SUD
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15
Q

prevalence of bipolar disorders: suicide and unemployment

A
  • suicide risks of people living with bipolar are 20% higher than found in general population
  • higher rates ofunemployment
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16
Q

etiology: biological

A
  • heritability
  • dysregulation in reward sensitivity
  • neurotransmitter dysfunction
  • functional and anatomical brain changes
17
Q

heritability

A
  • concordance rate: MZ=72%, DZ=14%
  • 65% of the variability in bipolar is genetic
  • complex genetic basis involving interactions among multiple genes
    1. bipolar 1 share genetic vulnerabilities with schizophrenia
    2. bipolar 2 strongly related to depressive disorders
18
Q

dysregulation in reward system

A
  • higher reward sensitivity + responding, leads to mania
  • excessive activation of the behavioural activation system
  • tendency to show anger and irritability in response to obstructed goals
19
Q

neurotransmitter dysfunction

A
  • higher glutamate level
  • certain drugs can trigger manic symptoms, suggesting neurotransmitters may play a role (SSRIs)
20
Q

functional and anatomical brain changes

A
  • less activation in emotion regulation areas
  • higher activation in emotional responsiveness areas
  • reduced hippocampal volume and neurocognitive impairment
21
Q

etiology: psychological

A
  • coping with stress
  • prone to rumination
  • cognitive deficits
22
Q

coping with stress

A
  • individuals tend to cope with stress by disengagement
  • tend to have limited adaptive coping and problem-solving skills
23
Q

cognitive deficits

A
  • problems in psychological flexibility in response to feedback
  • difficulty resricting irrelevant info when trying to achieve a goal
  • difficulty holding and manipulating info in mind
24
Q

etiology: social and sociocultural

A
  • early life stressors may lead to alterations in neurological functioning that increases vulnerability
  • loss of social support or strained social relationships can trigger onset of hypomanic/manic/depressive symptoms
25
Q

treatment goals

A
  • therapy attempts to support recovery and eliminate symptoms as much as possible
  • prevention of future episodes
26
Q

treatments

A
  • mood-stabilizing meds
  • psychotherapy
  • psychoeducation
27
Q

mood-stabilizing meds

A
  1. lithium
    - most effective for bipolar disorder
    - harmful side effects (kidney + thyroid function)
  2. anticonvulsants (new)
    - i.e. depakote, 50-60% response rate
  3. antipsychotics (new)
    - i.e. zyprexa
28
Q

non-adherence rate for meds is ____

A

high

29
Q

psychotherapy goal

A
  • prevent relapse and hospitalization
  • medication compliance
  • enhance psychosocial functioning
30
Q

psychotherapy: what is taught

A
  • psychoeducation about symptoms and causes and treatments
  • increase med compliance
  • identify signs of impending mood episode
  • teach communication and problem-solving skills to patient and family
  • practice emotional regulation techniques
  • understand dangers of substance abuse

Psychopathology PSYC 340 (14 decks)

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