1- Bipolar and related disorders - causes, symptoms, treatment & pathology (Updated 2024)

Source: https://www.youtube.com/watch?v=AWKFITL-ke8

Correct Answer: C. Bipolar disorder involves dramatic mood shifts occurring over days or weeks

Explanation: Clinically, bipolar disorder involves sustained mood episodes (mania, hypomania, depression) lasting days to weeks, not rapid mood changes.

Which statement best explains why the colloquial use of the term “bipolar” is inaccurate?

A. Bipolar disorder involves moment-to-moment mood swings
B. Bipolar disorder is identical to major depressive disorder
C. Bipolar disorder involves dramatic mood shifts occurring over days or weeks
D. Bipolar disorder only includes depressive symptoms

Correct Answer: C. Manic depression

Explanation: Bipolar disorder was historically referred to as manic depression.

Bipolar disorder was previously known as which condition?

A. Schizoaffective disorder
B. Unipolar depression
C. Manic depression
D. Cyclothymia

Correct Answer: C. Periods of elevated mood

Explanation: Bipolar disorders include manic or hypomanic episodes, which do not occur in unipolar depression.

Which of the following is a defining feature that distinguishes bipolar disorders from major depressive disorder?

A. Presence of hopelessness
B. Sleep disturbances
C. Periods of elevated mood
D. Loss of concentration

Correct Answer: C. 7 days

Explanation: Mania must last at least one week unless hospitalization occurs sooner.

A manic episode must last at least how long, unless hospitalization is required?

A. 2 days
B. 4 days
C. 7 days
D. 14 days

Correct Answer: B. Pressured speech

Explanation: Pressured, rapid speech is a classic symptom of mania.

Which symptom is MOST characteristic of a manic episode?

A. Excessive guilt
B. Pressured speech
C. Lead paralysis
D. Hypersomnia

Correct Answer: C. Need for hospitalization

Explanation: Hypomanic episodes do not require hospitalization and are less severe.

Which feature differentiates hypomanic episodes from manic episodes?

A. Presence of elevated mood
B. Duration of at least one week
C. Need for hospitalization
D. Increased energy levels

Correct Answer: C. 4 consecutive days

Explanation: The minimum duration for hypomania is four consecutive days.

Hypomanic episodes must last for at least:

A. 2 consecutive days
B. 3 consecutive days
C. 4 consecutive days
D. 7 consecutive days

Correct Answer: B. Euthymia

Explanation: Euthymia refers to a stable, baseline mood state.

What term describes the relatively stable mood state between mood episodes in bipolar disorder?

A. Dysphoria
B. Euthymia
C. Anhedonia
D. Cyclothymia

Correct Answer: B. At least one manic episode

Explanation: A single manic episode is sufficient for a Bipolar I diagnosis.

A diagnosis of Bipolar I disorder requires the presence of:

A. At least one hypomanic episode
B. At least one manic episode
C. At least one major depressive episode
D. Continuous mood symptoms for two years

Correct Answer: C. At least one hypomanic and one major depressive episode

Explanation: Bipolar II includes hypomania and major depression, without mania.

Which diagnostic criterion defines Bipolar II disorder?

A. Manic episodes only
B. Hypomanic episodes without depression
C. At least one hypomanic and one major depressive episode
D. Psychotic features during mood episodes

Correct Answer: C. Subthreshold hypomanic and depressive symptoms for at least two years

Explanation: Cyclothymia involves chronic, milder symptoms lasting at least two years.

Cyclothymic disorder is characterized by:

A. Severe manic and depressive episodes
B. One manic episode over a lifetime
C. Subthreshold hypomanic and depressive symptoms for at least two years
D. Rapid mood changes within a single day

Correct Answer: C. 1 year

Explanation: Symptoms must be present at least half the time over two years (≥1 year).

For cyclothymic disorder, symptoms must be present for at least:

A. 6 months
B. 9 months
C. 1 year
D. 2 years

Correct Answer: C. Rapid cycling

Explanation: Rapid cycling involves four or more mood episodes within one year.

Which specifier is defined by four or more mood episodes in 12 months?

A. Anxious distress
B. Melancholic features
C. Rapid cycling
D. Atypical features

Correct Answer: C. Atypical features

Explanation: Atypical features include mood reactivity, excessive sleep, and heavy limbs.

Mood reactivity combined with hypersomnia and leaden paralysis is characteristic of:

A. Melancholic features
B. Anxious distress
C. Atypical features
D. Psychotic features

Correct Answer: C. Lithium

Explanation: Lithium is a first-line mood stabilizer, especially effective for mania.

Which treatment is considered one of the oldest and most effective mood stabilizers for bipolar disorder?

A. SSRIs
B. Benzodiazepines
C. Lithium
D. Antipsychotics

Correct Answer: B. Manic episodes

Explanation: Lithium is more effective for manic episodes than depressive episodes.

Lithium is generally more effective in treating:

A. Depressive episodes
B. Manic episodes
C. Anxiety symptoms
D. Psychotic disorders

Correct Answer: C. They can trigger manic episodes

Explanation: SSRIs may induce mania in predisposed individuals.

Why can antidepressants like SSRIs be problematic in bipolar disorder?

A. They worsen depressive symptoms
B. They cause psychosis
C. They can trigger manic episodes
D. They are ineffective

Correct Answer: C. It helps prevent future manic episodes and manage stress

Explanation: Therapy is helpful for relapse prevention and coping but not acute mania.

Which statement about psychotherapy in bipolar disorder is MOST accurate?

A. It effectively treats acute manic episodes
B. It replaces medication treatment
C. It helps prevent future manic episodes and manage stress
D. It cures bipolar disorder

Correct Answer: B. Suicide

Explanation: Suicide risk is significantly elevated in bipolar disorder.

Individuals with bipolar disorder are at increased risk for:

A. Cardiovascular disease only
B. Suicide
C. Neurodegenerative disorders
D. Infectious diseases

Correct Answer: C. 10 times

Explanation: Family members have about a tenfold increased risk.

Having a first-degree relative with bipolar disorder increases a person’s risk by approximately:

A. 2 times
B. 5 times
C. 10 times
D. 20 times

Correct Answer: C. Psychotic features

Explanation: Hypomanic episodes do not include psychotic features, whereas manic episodes may.

Which feature may be present during manic episodes but is NOT present during hypomanic episodes?

A. Elevated mood
B. Increased energy
C. Psychotic features
D. Decreased need for sleep

Correct Answer: C. Hospitalization is required

Explanation: Mania lasting less than one week still qualifies if hospitalization is necessary.

Manic episodes may be diagnosed even if they last less than one week when:

A. The patient reports euphoria
B. The episode includes hypomania
C. Hospitalization is required
D. The patient has depression

Correct Answer: B. X-axis = time, Y-axis = mood

Explanation: Mood is plotted on the Y-axis and time on the X-axis.

The mood chart example described uses which axes?

A. X-axis = mood, Y-axis = time
B. X-axis = time, Y-axis = mood
C. X-axis = energy, Y-axis = mood
D. X-axis = symptoms, Y-axis = severity

Correct Answer: C. Normal ups and downs related to life events

Explanation: Neurotypical mood changes are situational and less extreme.

Compared with individuals with bipolar disorder, a neurotypical person typically experiences:

A. No mood changes
B. Moment-to-moment mood swings
C. Normal ups and downs related to life events
D. Continuous euthymia

Correct Answer: C. Anxious distress

Explanation: Anxious distress includes restlessness and fear of impending harm.

Which specifier is characterized by restlessness and fear that something terrible may happen?

A. Melancholic features
B. Atypical features
C. Anxious distress
D. Rapid cycling

Correct Answer: C. Melancholic features

Explanation: Melancholic features include guilt, early awakening, and worse mood in the morning.

Feeling guilty for no apparent reason and waking earlier than usual are features of:

A. Atypical features
B. Anxious distress
C. Melancholic features
D. Rapid cycling

Correct Answer: C. Mood brightening in response to positive events

Explanation: Mood reactivity is a key requirement of atypical features.

Which feature is MOST associated with atypical features in bipolar disorder?

A. Worse mood in the morning
B. No response to positive events
C. Mood brightening in response to positive events
D. Delusions of grandeur

Correct Answer: B. Lead paralysis

Explanation: Atypical features include hypersomnia and leaden paralysis.

Excessive daytime sleepiness and a heavy feeling in the limbs are referred to as:

A. Psychomotor retardation
B. Lead paralysis
C. Catatonia
D. Somatic delusions

Correct Answer: C. It involves genetic and environmental factors

Explanation: No single gene has been identified; both genetics and environment contribute.

Which statement best reflects current understanding of the cause of bipolar disorder?

A. It is caused by a single identified gene
B. It is purely environmental
C. It involves genetic and environmental factors
D. It results from childhood trauma alone

Correct Answer: C. Autism spectrum disorder only

Explanation: Bipolar disorder commonly coexists with anxiety, substance use, ADHD, and personality disorders.

Which conditions commonly co-occur with bipolar disorder, making diagnosis more challenging?

A. Anxiety disorders and substance use disorders
B. Dementia and Parkinson’s disease
C. Autism spectrum disorder only
D. Eating disorders only

Correct Answer: B. It can abruptly worsen mood instability

Explanation: Stopping medications suddenly can lead to relapse or severe mood episodes.

Why is medication non-adherence particularly dangerous in bipolar disorder?

A. It delays diagnosis
B. It can abruptly worsen mood instability
C. It eliminates therapeutic effects permanently
D. It prevents psychotherapy from working

Correct Answer: C. They may be used as part of treatment but have significant side effects

Explanation: Benzodiazepines may be used but carry risks and side effects.

Which statement best describes benzodiazepines in the treatment of bipolar disorder?

A. They cure bipolar disorder
B. They are primary long-term mood stabilizers
C. They may be used as part of treatment but have significant side effects
D. They are safer than lithium

Correct Answer: C. Managing stress and preventing future episodes

Explanation: Therapy helps with coping, stress management, and relapse prevention.

Psychological therapies are MOST useful in bipolar disorder for:

A. Treating acute manic episodes
B. Eliminating the need for medication
C. Managing stress and preventing future episodes
D. Diagnosing bipolar subtypes

Correct Answer: B. Involves periods of stable mood

Explanation: Individuals often return to a stable mood between episodes.

The presence of euthymia between episodes suggests that bipolar disorder:

A. Is a continuous mood disorder
B. Involves periods of stable mood
C. Always worsens over time
D. Eliminates emotional responses