Bipolar Disorder Background

Bipolar Disorder definition

common, life-long, often severe cyclic mood disorder with recurrent mood, energy and behavior functions

What is rapid cycling bipolar disorder?

Occurrence of 4 or more mood episodes in 1 year (major depressive, hypomanic, or manic).

Patients with rapid cycling bipolar disorder have a ______________ (better/poorer) prognosis.

poorer

Which neurotransmitters may be deficient in patients with bipolar disorder?

catecholamines and acetylcholine

Which neurotransmitters may be in excess in patients with bipolar disorder?

dopamine and GABA

Name some common disorders associated with the development of bipolar disorder (8).

1. head trauma

2. stroke

3. dementia

4. brain tumors

5. infection

6. multiple sclerosis

7. hyperthyroidism

8. post partum

Name the medications most commonly associated with bipolar disorder (8).

1. antidepressants (esp SNRIs)

2. decongestants

3. stimulants

4. caffeine

5. alcohol

6. amphetamines

7. corticosteroids

8. cocaine

What patients should be screened for bipolar disorder?

young adults to age 40 with risk factors

What risk factors warrant screening for bipolar disorder (5)?

1. family history

2. head trauma

3. stressors

4. psychiatric diagnosis (esp depression)

5. meds know to contribute to bipolar disorder

What are the key indicators for screening for bipolar disorder (5)?

1. hyperactivity or irritability

2. excessive self-confidence, socialization or talkativeness

3. reduced need for sleep

4. racing thoughts, increased energy or activity

5. risky decisions

What is the primary screening tool used for bipolar disorder?

MDQ

What is bipolar one?

at least one episode of mania alternation with MDD

What is bipolar two?

one or more hypomanic episodes alternating with MDD

Psychosis is ___________ (often/not) present in bipolar 1 and __________ (often/not_ present in bipolar 2.

often, not

True/False: Patients with bipolar 1 usually have slightly impaired to improved functioning while patients with bipolar 2 usually have impaired functioning.

False - patients with bipolar 2 usually have slightly impaired to improved functioning while patients with bipolar 1 usually have impaired functioning.

Episodes are usually ________ (longer/shorter) in patients with bipolar 1 than in patients with bipolar 2.

longer (months vs weeks)

DSM 5 Criteria for Bipolar 1

Criterion A: elevated, expansive or irritable mood + increased goal directed activity lasting at least 1 week most of the day nearly every day

Criterion B: at least 3 manic episode symptoms (GIDDINESS)

Criterion C: causes impairment/decreased function

Criterion D: Not attributable to disease/substance

DSM 5 Criteria for Bipolar 2

Criterion A: elevated, expansive or irritable mood + increased goal directed activity lasting at least 4daus most of the day nearly every day

Criterion B: at least 3 manic episode symptoms (GIDDINESS)

Criterion C: causes noticeable change from usual behavior but not significant impairment/decreased function

Criterion D: Not attributable to disease/substance

Name the mania/hypomania symptoms (GIDDINESS)

1. Grandiose; increased self-esteem

2. Increased goal-directed activity

3. Decreased judgement

4. Distractibility (flight of ideas)

5. Irritability

6. Needs less sleep

7. Speedy talking/increased talking

8. Speeding thoughts

Name the major depressive symptoms (D-SIGECAPS-L)

1. Depressed mood most of the day, nearly every day

2. Sleep changes

3. Interest is diminished

4. Guilt

5. Energy loss

6. Concentration challenges

7. Appetite changes

8. Psychomotor agitation or retardation

9. Suicidal thoughts

10. Low mood