Pad- Week 6: Bipolar & Dissociative Disorders

Front 1

1.List the 3 Main Bipolar Disorders

2.List the 4 others that are related or a bit dodgy

Back 1

1. Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder

2. Substance/medication induced
Bipolar or related disorder due to medical condition
Other specified bipolar or related disorder
Unspecified Bipolar or related disorder (aka. not meeting full criteria but insufficient info to be more specific)

Front 2

Current Episode= MDE
Diagnosis= Bipolar I
What past episodes must have happened? (2)

Back 2

None or MDE

Front 3

Current= MDE
Diagnosis= Bipolar I
Past Episodes=?? (3)

Back 3

Manic, +/- or Any others

Front 4

Current= MDE
Diagnosis= Bipolar II
Past Episodes=? (3)

Back 4

Hypomanic, MDE or +/-

Front 5

Current= Hypomanic
Diagnosis= Bipolar I
Past Episodes=? (3)

Back 5

Manic, +/- or Any others

Front 6

Current= Hypomanic
Diagnosis= Bipolar II
Past Episodes=? (2)

Back 6

MDE or Hypomanic

Front 7

Current= Manic
Diagnosis= Bipolar I
Past Episodes=? (3)

Back 7

MDE, Manic or None

Front 8

For Bipolar ____ disorder, you need to have at least one High and one Low episode

For Bipolar __ Disorder, you only need 1 Manic episode for diagnosis

Back 8

II

I

Front 9

Does an Episode= a Disorder?

Back 9

Nope! An episode could occur in the context of more than one disorder (eg. MDE could be due to MDD, Bipolar, or something else)

Front 10

Can you diagnose a disorder from a single episode?

Back 10

Yes!

Front 11

CRITERIA A for a Manic Episode:
Abnormally & _______________
i) __________, __________ or ___________ mood
and
ii) Increased ____ _________ or _______

For how long?

Back 11

Persistently
Elevated, Expansive, Irritable
Goal Activity, Energy
1 Week+

Front 12

CRITERION B:
For a Manic Episode: you need __ of the following (__ if the mood is ___________)
1. Inflated _________ or ___________
2. Decreased need for ______
3. More __________ than usual
4. _____ of _______, or _______ thoughts
5. D______________
6. Increase in _____-_________ activity or psychomotor _________
7. Excess involvement in activities with a ____ ____ for ________ consequences

Back 12

3, 4, Irritable
1. Self Esteem, Grandiosity
2. Sleep
3. Talkative
4.Flight of Ideas, Racing
5. Distractibility
6. Goal-Directed, Agitation
7. High Risk, Negative

Front 13

CRITERION C: Manic Episode
Marked impairment in ______/___________ functioning OR ____________ OR _________ features

Back 13

Social/ Occupational, Hospitalisation, Psychotic

Front 14

CRITERION D: Manic Episode
It can't be due to the effects of__________ use or ________ condition.

Back 14

Substance, Medical

Front 15

True or false:
A manic client may be difficult to distinguish from schizophrenia/ schizophreniform

Back 15

TRUE!

Front 16

True or False:
Manic patients are unable to restrain themselves in interviews and won't be able to mislead you with plausible explanations for their unusual behaviour

Back 16

FALSE!

Front 17

Prevalence: In MDD, Women__ Men, but in Bipolar, Women __ Men

Back 17

>, =

Front 18

The mean age of onset for MDD is ____ 20's, and for Bipolar is _____ 20's

Back 18

Late, Early

Front 19

Is there a link between social class and MDD?

What about Bipolar?

Back 19

No,

Yes, more prevalent in higher Social economic status

Front 20

Aetiology of Bipolar: NEUROTRANSMITTER HYPOTHESIS

Serotonin's main function is to ...?

Low Serotonin leads to...?

Back 20

Regulate emotional reactions by regulating other neurotransmitters

Impulsivity and bigger mood swings

Front 21

Briefly outline the main points of the "permissive hypothesis"

Low Norepinephrine=

High Norepinephrine=

Back 21

- Low serotonin lets other neurotransmitters vary more widely/ become dysregulated which leads to mood irregularities

Depression

Mania

Front 22

Outline the Circadian Rhythm hypothesis:

Give 4 things of evidence for it:

Back 22

Disruption in circadian rhythyms in vulnerable people can lead to a mood episode

1. Sleep disturbance is a key feature of most mood disorders

2. Abnormalities of sleep stages have been reported, esp in MDD

3. Seasonal Affective Disorder is triggered by changes in sleep/wake cycle and can be treated with light therapy

4. Manic episodes can be triggered by insomnia

Front 23

Bipolar disorders are ____________ heritable, but without full ____________ in monozygotic twins. There is _____ than __ genetic locus

Back 23

Strongly, Concordance, More, 1

Front 24

What are some possible inherited traits that predispose to Bipolar? (3)

Back 24

Cognitive vulerabilities (eg. attitudes, problem solving)
Neurotransmitter dysregulation
Sensitivity to Circadian rhythm dysruption

Front 25

Mania and Hypomania both involve abnormally and persistently ________ mood & ______-________ activity, however, they differ in _________ and __________

Back 25

elevated, goal-directed, duration, severity

Front 26

Mania: Duration must last....?

Hypomania: Duration must last...?

Back 26

1 week or more

4 Days or more

Front 27

Mania: must cause marked ___________: determined by ____________ functioning, or ________________, or ___________ features

Which of these features are NOT present in Hypomania?

HOWEVER....

Back 27

Impairment, Occupational, Hospitalisation, Psychotic

Marked impairment, hospitalisation, psychotic features

...There is a clear change from normal behaviour and its observable by others.

Front 28

BIPOLAR II Disorder: Criterion A- GO!

What type of episode is a deal-breaker? Criterion B states that its...?

Back 28

Criteria met for AT LEAST JUAN HYPOMANIC episode and AT LEAST JUAN MDE

A Manic Episode- there has to have never been one

Front 29

Criterion C for BIPOLAR II: Hypomanic and depressive episodes are not better accounted for by ___________ spectrum, or other _________ disorders

Back 29

Schizophrenia, Psychotic

Front 30

Criterion D for BIPOLAR II: The symptoms of ___________ or the ____________ caused by frequent alternation between ________ and ___________ causes clinically significant __________ or __________ in functioning

Back 30

Depression, Unpredictability, Depression, Hypomania, Distress, Impairment

Front 31

Cyclothymic Disorder is the same as ________ Disorder in terms of ___________, but what's different?

Back 31

Dysthymic, Chronicity,

In Cyclothymic, presence of Full mood episodes will exclude this diagnosis

Front 32

CRITERION A: Cyclothymic disorder:
Over ___ Years, many periods with __________ symptoms and many with ____________ symptoms without...

Back 32

2, Hypomanic, Depressive, Episode criteria being met

Front 33

CRITERION B: Cyclothymic disorder:
At least _____ of the __ Years has been disrupted by periods of _____ symptoms with no more than __ ________ free of symptoms

Back 33

Half, 2, mood, 2 months

Front 34

CRITERION C: Cyclothymic disorder:
Criteria for what must have never been met? (3)

Back 34

Manic, Hypomanic, Major depressive Episodes

Front 35

CRITERION D: Cyclothymic disorder: Not better accounted for by _____________ or _________ disorder

E: Not due to a _______ or ___________ condition

F: Symptoms cause clinically significant _______/ ____________

Back 35

Schizophrenia, Psychotic

Substance, Medical

Distress/ Impairment

Front 36

List the Dissociative Disorders Group: (3 'Good' and 2 Dodgy)

Back 36

1. Dissociative Identity Disorder
2. Dissociative Amnesia (Including Dissociative Fugue)
3. Depersonalisation/ Derealisation disorder

4. Other specified Dissociative Disorder
5. Unspecified Dissociative Disorder

Front 37

List the 6 Medical treatments used for Bipolar:

Back 37

1. Lithium
2. Carbamazapine
3. Antipsychotics
4. Benxodiazepines
5. Antidepressants
6. ECT

Front 38

Psychosical treatment of Bipolar:
In manic episode, therapy is usually ___________ however management can include:
- Clear ______
- Reduction of external ___________
- ___________ scheduling

Back 38

Impossible, Limits, Stimulation, Activity

Front 39

Psychosical treatment of Bipolar:

Between episodes develop _______ _________ monitoring systems and ____________ plans for _____ of ________

Back 39

Early signs, contingency, loss insight

Front 40

CRITERIA A: Bipolar I Disorder:
Criteria have been met for at least ___ ________ or _______ __________

CRITERIA B: The Manic or MDEs are not better accounted for by ...??

Back 40

1 Manic or Mixed Episode

Schizophrenia spectrum disorder or other psychotic disorder

Front 41

The central theme of Dissociative Disorders is that there are ______________ or discontinuities in functions central to the integrity of the _____ or ____________ experience

Back 41

Disruptions, Self, Subjective

Front 42

List the functions that may be affected by a Dissociative Disorder
-C
-M
-I
-E
-P
-B
-M
-B

Back 42

-Consciousness
-Memory
-Identity
-Emotion
-Perception
-Body Representation
-Motor Control
-Behaviour

Front 43

The different Dissociative Disorders affect different functions! What are the main functions affected by:

-Dissociative Identity Disorder?
-Dissociative Amnesia?
-Depersonalisation/Derealisation disorder?

Back 43

- Identity and Memory
- Autobiographical Memory
- Perception

Front 44

Dissociative Identity Disorder is strongly associated with overwhelming __________ __________, though onset may be ______

Back 44

Childhood Trauma, Later

Front 45

Dissociative Amnesia is associated with various ________, including war, disasters and childhood maltreatment

Onset may be _______, and may remit when the ________ is _________

Back 45

Trauma, Sudden, Stressor, Removed

Front 46

Depersonalisation/ Derealisation disorder has a clear association with a history of _____________ _____________ trauma, especially ___________ abuse/__________

What may be an immediate precipitant? (2)

Back 46

Childhood interpersonal, emotional, neglect

High stress, Illicit drug use

Front 47

How do you distinguish DID from malingering or a factitious disorder?
In genuine DID:

1. help seeking is not __________ & often not focussed on an _____________ ____ _________(they usually come to help some other issue)
2. The personality that seeks treatment is rarely the ______________
3. Genuine DID try to ______ __________/ fakes are ready to ______ and ____ between the personalities
4.There are real _______________ _________ across alters.

Back 47

1. frequent, awareness of the Alters
2. "original"
3. hide symptoms, show, move
4. physiological changes