Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
26 Cards in this Set
- Front
- Back
Bipolar I Disorder |
1(+) manic episode (1+ major depressive episode) |
|
Bipolar II Disorder |
1(+) hypomanic episode 1(+) major depresive episode |
|
Cyclothymic Disorder |
Hypomanic symptoms Depressive symptoms Full criteria for MDD and hypomania not met |
|
DSM-5 Criteria: Manic Episode |
A. Distinct period of bad mood and persistent goal-directed activity/energy lasting 1 week for most of the day, every day B. 3+: infalted self-esteem/grandiosity; decreased sleep; talkative; flighty ideas; distractibility; goal-direct activity; excessive involvement in painful consequence activities C. impairs social/occupational functioning |
|
DSM-5 Criteria: Hypomanic Episode |
A. distinct period of abnormally elevated, expansive mood + increased energy, lasting 4 consecutive days, most days, all day B. 3+: grandiosity; decreased sleep; talkative; flighty ideas; distractibility; goal-direct activity; excessive involvement in painful conseqactivities C. change from when indiv is not symptomatic D. disturbances are observable by others |
|
DSM-5 Criteria: Cyclothymic Disorder |
A. 2 years there have been numerous periods with hypomanic+depressive nonqual symptoms B. the period haves been present for @ 1/2 time and not w/o symp for more than 2 months(1yrb) C. Can't be dx'd w/ major depressive, manic, hypomanic or other disorder D. symptoms cause clinically significant distress or impairment in social/occupational functioning |
|
What's the difference between Bipolar I and Bipolar II? and cyclothymia |
BI - Mania (clinically significant distress), at least 1 week BII - Hypomania at least 4 days + MDE Cyclothymia - Hypomanic symptoms, depressive symptoms, clinically signficant distress |
|
BD - Manic Symptoms |
Frequency, Intensity, Number, Duration Elated Mood: Normal: very excited to go to disneyland Mania: 7 year old repeatedly taken to the principal for giggling when no one else was Grandiose Behaviors: Normal - 7yro pretended to be a fireman Mania- 7yro thought police wanted to play |
|
What's the difference between ADHD and BD? |
ADHD- show a CONSTANT pattern of overactivity/distractibility Bipolar Disorder - shows a CHANGE from usual behavior to overactivity or distractibility |
|
What's the difference between CD/ODD and Bipolar Disorder? |
CD/ODD - irritability and dyregulation but also vindictibe, intentional and without guilt Bipolar Disorder - irritability and dysregulation with impulsivity and sense of omnipotence |
|
Prevalence: Bipolar Disorder |
Lifetime prevalence 1.8% (for I and II combined) Girls = Boys |
|
Comorbidities: Bipolar Disorder |
Anxiety Disorder (about 75%), during depression ADHD ODD/CD Substance Use Disorders (during manic states) Eating disorders - particularly BED - during depressive states |
|
Course: Bipolar Disorder |
20% of all patients have their first episode in late adolescence; onset before 10 is rare - childhood/adol onset is a more severe course, worse prognosis - youths with BDs typically recover from episode1, in 5 years 60% relapse/never recover - median duration of manic episodes is 10.8 mo - duration of mood disturbance is 80.2 mo |
|
Causes: Bipolar Disorder |
Strong genetic component (5-10x greater) Reduced brain volume Hyperactivation of the amygdala, hypoactivation of prefrontal cortex (see more threats) Lower frustration tolerance Perpetuating: high expressed emotion - critical, hostile, over-involved |
|
Treatment: Bipolar Disorder |
Atypical antipsychotic are often the first-line treatment now Mood stabilizers: lithium Antidepressants may create mania Psychotherapy may increase compliance with medication and prevent recurrence of symptoms |
|
Psychotherapy for Bipolar Disorder |
Psychoeducation, improving emotion-regulation and communication |
|
Lithium |
Low effectiveness, high drop-out rate, high side effects |
|
Atypical antipsychotics |
Approved in those 10-17 Affect dopamine, serotonin, and norepinephrine Bind more strongly to dopamine receptors, causing fewer side effects ~50% see reduction in manic symptoms (~25%) Response Rates ~2x as high as to lithium |
|
New Diagnosis in the DSM-5 |
40-fold increase in kids from 1994-2003 Biological relatives of kids with chronic irritability often have problems with anxiety and depression, not BD May lead to inappropriate medicinal treatment DMDD can now describe these children |
|
Disruptive Mood Dysregulation |
Severe recurrent TEMPER OUTBURSTS manifested verbally/behaviorally that are exag TOs are inconsistent with developmental level 3x+/week, mood inb/n TOs is irritable symptoms have been present for 12 mo and are present in at least two of three settings, 1 severe dx not made before 6 or after 18 by history/observ onset is before 10 yro |
|
Prevalence: DMDD |
~2-5% of those age 6-18 2/3 are male DMDD in childhood may be a risk factor for depressive disorders and GAD in adulthood |
|
Associated Characteristics: DMDD |
impaired face processing, particularly for negative emotions such as "sad", "fearful" and "angry" underactivity of the amygdala during face preception decreased context-sensitive regulation |
|
Treatment: DMDD |
Antidepressants, parent training, CBT, comprehensive family therapy |
|
Differences between DMDD and Bipolar Disoder |
Bipolar disorders are episodic while DMDD is persistent and present over many months No mania in DMDD (no elevated or expansive mood or grandiosity) |
|
Differences between DMDD vs ODD |
Mood symptoms are rare in ODD Remember, if the child meets the crtieria for both ODD an DMDD s/he is diagnosed with DMDD ONLY |
|
when DMDD symptoms occur ONLY during these situations, it's not DMDD |
anxiety-povoking context routines of a child with ASD or OCD temper outbursts occur in the presence of a mjaor depressive episode |