Transcript Document

Bipolar Disorder
An Overview of the Diagnosis
including Symptoms and Diagnostic
Criteria
Bipolar Disorders
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Like other psychiatric diagnoses, this category is complex and has
several subsets.
We will not specifically address all of the subsets, but I will list them
for you here.
Bipolar I Disorder
Single Manic Episode
Most Recent Episode Hypomanic
Most Recent Episode Manic
Most Recent Episode Mixed
Most Recent Episode Depressed
Most Recent Episode Unspecified
Bipolar II Disorder
Cyclothymia
Bipolar Disorder NOS (not otherwise specified)
Associated Features
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Mortality rate due to suicide of 10%-15%
Child abuse, spouse abuse, or other violent behavior may
occur during severe Manic Episodes
School truancy, school failure, occupational failure,
divorce, or episodic antisocial behavior.
Rapid and/or persistent speech (hyper-verbal; rumination)
No racial differentiation
No significant gender differences (unlike Maj. Dep. Dis.)
Male first episode is likely to be a Manic Episode
Female first episode likely to be a Maj. Dep. Epi.
Criteria for a Manic Episode
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A distinct period of
abnormally and
persistently elevated,
expansive, or irritable
mood, lasting at least 1
week (or any duration
if hospitalization is
necessary)
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During the period of
mood disturbance,
three (or more) of the
following symptoms
have persisted (four if
the mood is only
irritable) and have
been present to a
significant degree:
Criteria cont’d
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Inflated self-esteem or
grandiosity
Decreased need for sleep (e.g.,
feels rested after only 3 hours of
sleep)
More talkative than usual or
pressure to keep talking
Flight of ideas or subjective
experience that thoughts are
racing
Distractibility (i.e., attention too
easily drawn to unimportant or
irrelevant stimuli.
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Increase in goal-directed
activity (either socially, at work
or school, or sexually) or
psychomotor agitation
Excessive involvement in
pleasurable activities that have
a high potential for painful
consequences (e.g., engaging in
unrestrained buying sprees,
sexual indiscretions, or foolish
business investments)
Mood disturbance is sufficiently
severe to cause marked
impairments in life.
Course
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Recurrent disorder ~ more than 90% of individuals who
have a single Manic Episode go on to have future episodes.
60% - 70% of Manic Episodes occur immediately before
or after a Major Depressive Episode.
Majority of individuals return to fully functional state
between episodes, 20%-30% continue to display mood
lability.
Medically treated primarily with Lithium.