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24 Cards in this Set
- Front
- Back
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mean age of onset for bipolar disorder in men and women
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20 y/o
slightly younger in females |
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DSM IV criteria for manic episode:
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Criteria A: elevated, expansive, or irritable mood lasting at least 1 week (or any duration if hospitalization is necessary
Criteria B: -Inflated self-esteem or grandiosity -Decreased need for sleep -More talkative than usual or pressure to keep talking -Flight of ideas or the subjective feeling of racing thoughts -Distractibility -Increased goal-directed activity or psychomotor agitation -Excessive involvement in pleasurable activities that have a high potential for painful consequence CriteriaC:Not a Mixed Episode Criteria D: impairment in functioning; necessity for hospitalization; presence of psychotic features Criteria E: not due to drugs or medical condition |
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Mania: epidemiology
bipolar I bipolar II |
bipolar I
manic + depression 1-2% of adult pop. bipolar II hypomanic + depression 5% of adult pop. |
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mania
what percent of mood disorders? What percent go untreated? What percent end in suicide? |
10-20%
40% 15-25% |
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Mania: Course
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Onset- early 20’s; adolescence, after 50
Frequently follow psychosocial stressors Sudden onset with rapid escalation (days) Last weeks to months 50% of episodes followed my MDEs May be postpartum |
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Mania: Course Across lifetime
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Average of 8-10 episodes
4-6 years typically separates 1st and 2nd episodes Inter-episode interval typically grows shorter between the 2nd and 5th episodes, with subsequent episodes lasting about 18 months |
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Mania: Predictors of poor response
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Highly loaded family history(especially first degree relatives)
Early age of onset Severity of manic episode History of past suicide attempts Chronic course Rapid-cycling course |
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Hypomania
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A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood
During the period of mood disturbance, 3 or more symptoms of mania persist (4 if the mood is only irritable) to a significant degree Criteria C, D, and E of Mania Criteria |
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Cyclothymia
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For at least 2 years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a MDD
During the 2 year period (1 year in child and adolescents), the person has not been without the symptoms for more than 2 months No MDD, Manic or Mixed Episode has been present during the first 2 years of the disturbance[afterwards these diagnoses may be superimposed] |
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Mania: Treatment
Know this flashcard |
Start lithium, divalproex, psychotropic
If psychotic features add psychotropic If agitated add psychotrophic or benzodiazepine If poor response, add/change to another mood stabilizer, consider carbamazepine Bilateral ECT |
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Mania: Treatment
Lithium |
acute & maintenance treatment
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Mania: Treatment
Divalproex |
acute treatment
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Mania: Treatment
Olanzapine (in combination with lithium or valproate |
acute mania
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Mania: Treatment
Lamotrigine |
-“the maintenance treatment of BP I disorder to delay the time to occurrence of mood episode(depression, mania, hypomania, mixed episodes) in patients treated for acute mood episodes with standard therapy”
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Mania: Treatment
Zyrexa (olanzapine) - |
acute mania
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Mania: Treatment
Seroquel (quetiapine) - |
acute bipolar mania and/or mixed state
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Mania: Treatment
Risperidal (risperidal) - |
acute bipolar mania and/or mixed state
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Mania: Treatment
Abilify (aripiprazole |
acute bipolar mania
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Mania: Treatment
Geodon (ziprasidone) |
acute manic and/or mixed state
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Bipolar depression is less pervasive than mania T/F
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F
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Mean duration of the depressive episode in bipolar disorder is longer than manic episodes T/F
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T
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Depression is chronic in more than 20% of patients with bipolar disorder T/F
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T
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Recently introduced medications (anticonvulsants and atypical antipsychotics) have predominantly antimanic—rather than antidepressant—properties T/F
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T
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T/F patients with cyclical mood disorders typically take longer to get to a stable mood than unipolar patients
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T
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