3- Bipolar Disorder Explained Clearly

Source: https://www.youtube.com/watch?v=7qir8-ncvBA

Correct answer: C. At least one manic episode

Explanation:
Bipolar I disorder requires at least one manic episode. A depressive episode is not required for diagnosis, even though many patients eventually experience one.

Which of the following is required for a diagnosis of Bipolar I disorder according to DSM-5?

A. At least one major depressive episode
B. At least one hypomanic episode
C. At least one manic episode
D. Rapid cycling mood episodes

Correct answer: B. At least 7 days, or any duration if hospitalization is required

Explanation:
A manic episode must last ≥7 days, or any duration if hospitalization is necessary, regardless of duration.

Which criterion correctly defines the minimum duration of a manic episode in DSM-5?

A. At least 4 days
B. At least 7 days, or any duration if hospitalization is required
C. At least 2 weeks
D. At least 7 days with psychotic features

Correct answer: C. Rapid cycling

Explanation:
Rapid cycling is the correct DSM-5 term for ≥4 mood episodes in a 12-month period. “Rapid alternating” is not the formal term.

Which term is used to describe four or more mood episodes (mania, hypomania, or depression) occurring within one year?

A. Mixed features
B. Cyclothymia
C. Rapid cycling
D. Mood lability

Correct answer: C. It is most useful for relapse prevention and depressive symptoms

Explanation:
Psychotherapy (CBT, interpersonal therapy, psychoeducation) is most effective for depressive symptoms, relapse prevention, and medication adherence, but not for acute mania alone.

Which statement best describes the role of psychotherapy in bipolar disorder?

A. It is equally effective for acute mania and depression
B. It replaces medication in manic episodes
C. It is most useful for relapse prevention and depressive symptoms
D. It is ineffective in bipolar disorder

Correct answer: B. It prevents suicide and mood relapse

Explanation:
Lithium is highly effective for acute mania, relapse prevention, and reducing suicide risk, but it requires monitoring due to renal and thyroid side effects.

Which statement regarding lithium in bipolar disorder is MOST accurate?

A. It is most effective for acute bipolar depression
B. It prevents suicide and mood relapse
C. It does not require laboratory monitoring
D. It is ineffective for manic episodes

Correct answer: C. Electroconvulsive therapy (ECT)

Explanation:
ECT is reserved for severe or treatment-resistant cases, including severe depression or mania, especially when rapid improvement is required.

Which treatment is primarily used for severe or treatment-resistant bipolar episodes, particularly when rapid symptom control is needed?

A. Transcranial magnetic stimulation (TMS)
B. Cognitive behavioral therapy
C. Electroconvulsive therapy (ECT)
D. Psychoeducation

Correct answer: C. TMS is less invasive and mainly used for depressive episodes

Explanation:
TMS is less powerful, does not require anesthesia, and is mainly used for depressive episodes, whereas ECT is more effective for severe cases.

Which statement correctly compares ECT and TMS?

A. TMS is more powerful than ECT
B. Both require general anesthesia
C. TMS is less invasive and mainly used for depressive episodes
D. ECT is ineffective in bipolar disorder

Correct answer: C. They can trigger mania or rapid cycling

Explanation:
Antidepressants can trigger manic episodes or accelerate cycling when used without a mood stabilizer.

Why are antidepressants not typically used alone in bipolar disorder?

A. They worsen depressive symptoms
B. They have no effect on mood
C. They can trigger mania or rapid cycling
D. They cause psychosis in all patients

Correct answer: C. Olanzapine + fluoxetine

Explanation:
The olanzapine–fluoxetine combination is specifically approved for the treatment of bipolar depression.

Which medication combination is FDA-approved for bipolar depression?

A. Lithium + valproate
B. Haloperidol + carbamazepine
C. Olanzapine + fluoxetine
D. Lamotrigine + quetiapine

Correct answer: C. Marked impairment in social or occupational functioning

Explanation:
Mania causes marked functional impairment, may require hospitalization, and may include psychosis.
Hypomania does not cause significant impairment and does not include psychotic features.

Which feature distinguishes hypomania from mania according to DSM-5?

A. Presence of elevated mood
B. Increased goal-directed activity
C. Marked impairment in social or occupational functioning
D. Decreased need for sleep

Correct answer: C. Psychosis can occur during manic episodes but not hypomanic episodes

Explanation:
Psychotic features may occur in mania, but never in hypomania. Their presence automatically qualifies the episode as manic.

Which statement regarding psychotic symptoms in bipolar disorder is MOST accurate?

A. Psychosis may occur in both mania and hypomania
B. Psychosis is required for a diagnosis of mania
C. Psychosis can occur during manic episodes but not hypomanic episodes
D. Psychosis only occurs during depressive episodes

Correct answer: C. It is less effective for acute bipolar depression but helps prevent relapse

Explanation:
Lithium is highly effective for acute mania and long-term relapse prevention, but is less effective for treating acute bipolar depression compared with its antimanic effects.

Which statement best describes lithium’s role in bipolar depression?

A. It is the most effective treatment for acute bipolar depression
B. It worsens depressive symptoms
C. It is less effective for acute bipolar depression but helps prevent relapse
D. It should only be used with antidepressants