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9 Cards in this Set

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What are DSM IV criteria for bipolar?
MUST HAVE WEEK-LONG MANIC EPISODE (irritable, elevated, grandiose). Decreased need for sleep (increased energy), pressured speech, poor judgement/insight. Can have psychotic symptoms. MUST ALSO HAVE MAJOR DEPRESSIVE EPISODE

Women more depressive episodes. Men more manic episodes.
What is the difference between mania and hypomania?
Hypomania - not as extreme as mania. no functional impairment. yes, still noticed by others.
What is a mixed episode?
Women have higher prevalence. FULL manic and depressive symptoms for a week. Some need for hospitalization.
First affective episode in Bipolar I? Bipolar II?
38.8% depression. 96% Depression for BIPOLAR II

More time is spent in depression than in mania.
Differences between Bipolar I and Bipolar II
Bipolar I - at least one MANIC or MIXED EPISODE. Depression generally present

Bipolar II - NEVER HAD MANIC EPISODE. AT LEAST ONE HYPOMANIC EPISODE. One or more depressive episodes. 96% of first affective episodes is depression.
Onset
Bimodal. MORE SEVERE IN YOUTH (insight, drug use, self-injury). 15-19 peak onset.

Elderly due to brain lesions/infarctions. Basal forebrain. R hemispheric injury
What biochemical changes occur in Bipolar?
5-HT: HYPOFUNCTION of serotonin in BOTH depressive and manic episodes

DOPAMINE: HYPERACTIVE in MANIC episode. Antidopamingeric meds are antimanic

GABA - GABAergic meds are antimanic

GLUTAMATE - Antiglutaminergic meds are MOOD STABILIZERS mostly helping w depression
Genetic Vulnerability to Bipolar?
80% Concordance in MONOZYGOTIC TWINS
Brain Structures involved in Bipolar?
Prefrontal Cortex: Behavioral Inhibtion/Attention/Motivation

Limbic Systems: Amygdala.