Bipolar Disorders - Lecture Notes Flashcards

A comprehensive set of Q&A style flashcards covering Bipolar I, Bipolar II, cyclothymic disorder, risk factors, manic episode criteria, acute mania interventions, self-care, communication, medications, psychotherapy, education, assessment, and safety outcomes.

What distinguishes Bipolar I Disorder in terms of episodes?

Episodes of mania and depression; psychotic or catatonic features may be present; 4 or more episodes in one year qualifies as rapid cycling.

What is the global disability impact of bipolar disorder?

Second only to major depression as a cause of worldwide disability.

What are the diagnostic criteria for a manic episode?

A distinct period of elevated/expansive mood with increased goal-directed activity or energy for at least 1 week plus 3 or more symptoms (inflated self-esteem/grandiosity, decreased need for sleep, pressured speech, flight of ideas/racing thoughts, distractibility, increased goal-directed activity, risky or excessive involvement in painful activities); the mood disturbance causes marked impairment and is not due to substances or another medical condition.

What defines Bipolar II Disorder?

Episodes of depression and hypomania; never experienced a full manic episode; irritability and frequent depressive episodes are common; symptoms are not severe enough to cause marked impairment.

What is cyclothymic disorder?

At least 2 years of fluctuating hypomanic symptoms that do not meet criteria for hypomanic episodes, alternating with minor depressive episodes.

What are the main risk factors for bipolar disorder?

Genetics; neurobiologic and neuroendocrine factors; environmental stress that can trigger symptoms in individuals with genetic susceptibility.

What are key interventions during acute mania?

Focus on safety and physiological needs: provide a safe environment, assess for suicidal thoughts or escalating behavior, decrease stimulation without isolating the client, one-to-one observation or seclusion if needed, provide outlets for physical activity, protect from poor judgment or impulsive behaviors.

What self-care measures are important for manic patients?

Monitor sleep, fluid intake, and nutrition; provide portable, nutritious food; reminders for hygiene and changing clothes.

What communication approaches support manic patients?

Use a calm, matter-of-fact approach with concise explanations; set limits; avoid power struggles; reinforce nonmanipulative behaviors; use therapeutic communication techniques.

What mood stabilizers are used in bipolar disorder?

Lithium carbonate as a mood stabilizer.

Which anticonvulsants are used for bipolar disorder, and in what contexts?

Valproate and carbamazepine for acute mania; lamotrigine for maintenance therapy.

Which antipsychotics are used in bipolar disorder, and for what purpose?

Olanzapine and risperidone (examples); lurasidone and quetiapine are approved for bipolar depression.

What is cautioned about antidepressants in bipolar disorder?

Antidepressants (SSRI, etc.) can be used in major depressive episodes but should not be used alone, as they can trigger manic episodes.

When is psychotherapy useful in bipolar disorder?

Useful during mildly depressive or euthymic (normal) portions of the bipolar cycle; not useful during manic stages.

What should client education cover for bipolar disorder?

Long-term condition requiring medication and psychological support; importance of therapy and support groups to prevent relapse; signs of pending relapse; triggers; importance of a healthy lifestyle; medication adherence and education.

What are key aspects of bipolar disorder assessment?

History; general appearance and motor behavior; mood and affect; thought process and content; sensorium and intellectual processes; judgment and insight; self-concept; roles and relationships; physiological and self-care considerations.

What are common safety and behavioral outcomes in bipolar disorder?

No injury to self or others; balance of rest, sleep, and activity; socially appropriate behavior.