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37 Cards in this Set
- Front
- Back
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Manic Episode: A distinct period of ___ and ___, representing ___, lasting ___ and ___. (Criterion A) |
Manic Episode: A distinct period of _abnormally and persistently elevated, expansive or irritable mood_ and _abnormally and persistently increased goal-directed activity/energy_, representing _a marked change in behavior_, lasting _at least 1 week_ and _present nearly every day (or any duration if hospitalization necessary)_. |
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What are the symptoms of a manic episode? (Criterion B) |
Distractibility: attention too easily drawn away, as reported/observed Increased goal-directed activity (socially/sexually/academically/occupationally) or increased psychomotor agitation Grandiosity/increased self-esteem Flight of ideas or racing thoughts excessive involvement in Activities with high potential for painful consequences (spending, sex, substances, driving, etc.) decreased need for Sleep (i.e. feels rested after only 3 hours sleep) more Talkative than usual or pressure to keep talking Mnemonic: DIG FAST |
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How many symptoms need to be present during the manic episode? (Criterion B) |
3+, or 4+ if mood is only irritable |
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What is Criterion C for a manic episode? ( The mood disturbance is ___ or ___.) |
The mood disturbance is _sufficiently severe to cause marked impairment in social or occupational functioning,_ or _to necessitate hospitalization to prevent harm to self or others,_ or _there are psychotic features_. |
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What is Criterion D for a manic episode? (The episode is ___ or ___.) |
The episode is _not attributable to the physiological effects of a substance (drug of abuse, medication, etc.)_ or _to another medical condition_. |
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What are the criteria for a manic episode? (four criteria) |
Following criteria must be meet for a manic episode: A. elevated/expansive/irritable mood & increased energy/activity for 7+ days B. 3+ (or 4+ if only irritable) of following: -Distractibility-Increased goal-directed activity/PMA-Grandiosity-FOA/racing thoughts-excessive Activities with high risk of painful consequences-decreased need for Sleep-Talkativeness C. causes marked impairment or requires hospitalization or psychosis present D. not due to substance or AMC |
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A manic episode emerging during antidepressant tx that persists beyond that tx is sufficient evidence for documentation of a manic episode: T or F? |
True |
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What is required for a diagnosis of Bipolar I disorder? |
At least one lifetime manic episode. |
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How long does a hypomanic episode last? How long do the symptoms last? |
at least 4 days. Symptoms present most of the day, nearly every day. |
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What is the difference between the criteria for a hypomanic episode and a manic episode? |
Length of period of mood disturbance and increased energy/activity is 4+ days for hypomanic and 7+ days for manic (Criteria A & B). The hypomanic episode is associated with unequivocal and uncharacteristic change in function (Criterion C) The disturbance in mood is observable by others (Criterion D) The hypomanic episode is not severe enough to cause marked impairment or require hospitalization or no psychosis present(Criterion E)
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Hypomanic episodes are common in Bipolar I disorder: T or F? |
True |
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Hypomanic episodes are required for dx of Bipolar I disorder: T or F? |
False |
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___symptoms present during the same ___ are needed for a Major Depressive Episode. One symptom must be either ___ or ___. (Criterion A) |
at least 5 2 week period depressed mood or loss of interest/pleasure |
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What are the criteria for a Major Depressive Episode? (three criteria) |
A. 5+ symptoms during 2-week period including either depressed mood or anhedonia: -Depressed mood-SIG E CAPS B. symptoms cause significant impairment/distress C. not due to substance/AMC |
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How do you distinguish grief from MDE? |
1) grief predominant affect: feelings of emptiness/loss vs persistent depression in MDE 2) grief: dysphoria decreases over time & comes in waves ("pangs of grief") associated with thoughts of deceased vs persistent dysphoria without association in MDE 3) grief: pain may be associated with positive emotions/humor vs pervasive unhappiness in MDE 4) grief: TC preoccupation with thoughts of deceased vs self-critical/pessimistic ruminations of MDE 5)grief: self-esteem generally preserved or derogatory ideations involves failings regarding deceased vs feelings of unworthiness/loathing common in MDE 6) grief: thoughts of death/dying focused on "joining" deceased vs focus on ending life due to feeling unworthy/undeserving/unable to cope with pain of depression |
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What are the criteria for Bipolar I disorder? (two criteria) |
A. criteria for at least one manic episode met. B. manic/depressive episodes not better explained by psychotic disorders. |
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What are the criteria for Bipolar II disorder? (four criteria) |
A. criteria met for 1+ Hypomanic Episode and 1+ MDE. B. pt has never had Manic Episode C. symptoms not better explained by psychotic d/o. D. symptoms cause significant distress/impairment. |
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What is the length of time needed for symptoms in Cyclothymic Disorder? |
At least 2 years for adults (1 year for children or adolescents) |
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Cyclothymic Disorder includes criteria for either Manic, Hypomanic or MD Episodes: T or F? |
False |
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In Cyclothymic Disorder, there are numerous periods with hypomanic symptoms that do not meet criteria for a Hypomanic Episode AND numerous periods with depressive symptoms that do not meet criteria for a MDE: T or F? |
True |
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In Cyclothymic Disorder, the hypomanic and depressive periods have been present ___ and the individual ___. |
In Cyclothymic Disorder, the hypomanic and depressive periods have been present _for at least half the time_ and the individual _has not been without symptoms for more than 2 months at a time_. |
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What are the criteria for Cyclothymic Disorder? (six criteria) |
A. 2+ years (1+ in child/adolescents), many periods of hypomanic & depressive symptoms not meeting criteria for full Episodes B. Periods present 50+% of time and never absent for > 2m at a time. C. Manic, Hypomanic or MD episode criteria never met. D. not better explained by psychotic disorder. E. not due to substance/AMC. F. cause significant distress/impairment. |
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What is the specifier for Cyclothymic Disorder? |
With anxious distress |
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What are the criteria for Substance/Medication-Induced Bipolar and Related Disorder? (five criteria, with one two-part criterion) |
A. Elevated/expansive/irritable mood +/- depressed mood or anhedonia. B1. Evidence that Crit A symptoms developed in context of intox/WD or exposure to med B2. Involved substance/med can cause Crit A symptoms. C. not better explained by other bipolar d/o. D. does not occur exclusively during delirium. E. causes significant distress/impairment. |
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What are the criteria for Bipolar and Related Disorder Due to Another Medication Condition? (five criteria) |
A.Elevated/expansive/irritable mood and increased energy/activity B. Evidence that Crit A symptoms developed in context of AMC. C. not better explained by other mental d/o. D. does not occur exclusively during delirium. E. causes significant distress/impairment. |
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What are the specifiers for Bipolar and Related Disorder Due to Another Medication Condition? |
with manic features with manic- or hypomanic-like features (attributable to substance) with mixed features (depressive symptoms present) |
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When do you use Other Specified Bipolar and Related Disorder dx instead of Unspecified B & RD? |
Other Specified B&RD to indicate specific reason criteria not met (and must list specific reason)
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What are the specifiers for Bipolar and Related Disorders? |
with mood-congruent psychotic features with mood-incongruent psychotic features with catatonia with rapid cycling with anxious distress with atypical features with mixed features with melancholic features with peripartum onset with seasonal pattern Mnemonic: ICy (incongruent-congruent) CRAAMMPS |
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what are the criteria for the specifiers "with mood-congruent psychotic features" & "with mood-incongruent psychotic features"? |
mood-congruent: delusions or hallucinations consistent with manic +/- paranoid themes
mood-incongruent: delusions or hallucinations inconsisten with manic +/- paranoid themes, or mix of congruent/in-congruent themes. |
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what are the criteria for the specifier "with catatonia"? |
catatonic features present |
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what are the criteria for the specifier "with rapid cycling"? |
presence of 4+ mood episodes in last 12 months (episodes demarcated by either 2+ months of partial/full remission or switch to opposite episode) |
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what are the criteria for the specifier "with anxious distress"? |
presence of 2+ symptoms during majority of current/most recent episode: 1) difficulty concentrating due to Worry 2) feeling unusually Restless 3) fear something Awful may happen 4) feeling pt may lose Control 5) feeling Keyed up or tense. Mnemonic: WRACK |
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what are the criteria for the specifer "with atypical features"? |
mood reactivity & 2+ of following: 1) Leaden paralysis 2) Appetite/weight increase 3) long-standing pattern of interpersonal rejection Sensitivity causing significant impairment 4) Hypersomnia Mnemonic: MR LASH |
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what are the criteria for the specifier "with mixed features?" |
full criteria of manic/hypomanic episode with 3+ symptoms of MDE or, full criteria of MDE with 3+ symptoms of mania not due to substance/med |
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what are the criteria for the specifier "with melancholic features"? |
1 of following: 1) Lack of reactivity to pleasurable stimuli 2) Anhedonia and 3+ of following: 1) Psychomotor agitation/retardation 2) Appetite/weight loss 3) excessive/inappropriate Guilt 4) Early-morning awakening (2+ hours early) 5) Depression worse in morning 6) profound despondent/despair or empty mood Mnemonic: LA PAGEDD |
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what are the criteria for the specifer "with peripartum onset"? |
onset of symptoms during pregnancy or in 4 weeks following delivery |
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what are the criteria for the specifier "with seasonal pattern"? |
A. regular temporal pattern between onset of epsiode(s) and particular time of year B. full remission occurs at particular time of year C. temporal pattern of episodes occurred for past 2 years with no exceptions D. Seasonal episodes substantially outnumber non-seasonal episodes over lifetime |
