Title 10 AbPsy - Bipolar and Related Disorders.pdf ✅

10 – Bipolar and Related Disorders ABPSY | 2024 - 2025 | NOT FOR SALE OUTLINE 1. Defining Bipolar Disorders 2. Bipolar I Disorder 3. Bipolar II Disorder 4. Cyclothymic Disorder DEFINING BIPOLAR DISORDERS BIPOLAR AND RELATED DISORDERS Bipolar Disorders – mood disturbance in which the experiences both depressive and manic episodes; alternates between depression and mania ● Manic Episode: abnormal, persistent elevated, expansive or irritable mood and abnormal, persistent increased goal-directed activity or energy most of the day, nearly every day for at least 1 week (any duration if hospitalized) ○ Individuals find extreme pleasure in every activity ○ Comparable to a continuous sexual orgasm ○ Speech is typically rapid and may become incoherent in an attempt to express so many exciting ideas at once (flight of ideas) ● Hypomanic Episode: abnormal, persistent elevated, expansive or irritable mood and abnormal, persistent increased goal-directed activity or energy most of the day, nearly every day for at least 4 days ○ Hypo = below ○ Less severe version of a manic episode ○ Does not cause marked impairment in social or occupational functioning ● Major Depressive Episode: extremely depressed mood state that lasts at least 2 weeks and includes cognitive symptoms and disturbed physical functions ○ Typically accompanied by a general loss of interest in things and an inability to experience any pleasure from life ○ The most central indicators of a full major depressive episode are the physical changes (sometimes called somatic or vegetative symptoms) ● Highly comorbid with anxiety disorders (75%) 1 | @studywithky
SPECIFIER DESCRIPTION Anxious Distress Presence and severity of accompanying anxiety, whether in the form of comorbid anxiety disorder or anxiety symptoms that do not meet all the criteria for disorders Makes suicidal thoughts and completed suicide more likely, and predicts a poorer outcome from treatment Rapid Cycling Moving quickly in and out of depressive or manic episodes At least 4 manic or depressive episodes within a year Does not respond well to standard treatments Has a higher probability of suicide attempts and more severe episodes of depression Also called rapid switching or rapid mood switching Melancholic Features Applies only if the full criteria for a major depressive episode have been met Severe somatic (physical) symptoms, such as early-morning awakenings, weight loss, loss of libido, excessive or inappropriate guilt, and anhedonia Atypical Features Consistently oversleep and overeat during their depression Have considerable anxiety, but they can react with interest or pleasure to some things Psychotic Features Experiences hallucinations and delusions alongside depressive episodes Mood-Congruent: delusions of grandeur accompanying a manic episode Catatonia Catalepsy Peripartum Onset Depression a period of time just before and just after the birth Seasonal Pattern Episodes that occur during certain seasons BIPOLAR I DISORDER DEFINING BIPOLAR I DISORDER Bipolar I Disorder – at least one lifetime manic episode (hypomanic episode or major depressive episode may occur but not required) ● One of the most common features of a manic episode is a decreased need for sleep ● Speech can be rapid, pressured, loud, and difficult to interrupt ● Symptoms of mania in BP1 occur in distinct episodes and typically begin in late adolescence or early adulthood ○ There must be a symptom free period of at least 2 months between manic and major depressive episodes ○ First episode is usually depressive and its symptoms are the most frequent symptoms experienced ● Peaks between 20 and 30 years, but onset occurs throughout the lifespan DIAGNOSTIC CRITERIA A. Criteria have been met for at least one manic episode (Criteria A-D under “Manic Episode” above). B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. CAUSES / RISK FACTORS Environmental Risks ● Common in high-income countries ● Separated, divorced, or widowed individuals Genetic and Physiological ● Family history of bipolar disorder (10-fold increased risk) ● Magnitude of risk increases with degree of kinship Suicide Risk ● Account for one-quarter of all completed suicides ● A past history of suicide attempt and percent days spent depressed in the past year are associated with greater risk of suicide attempts or completions. Course Modifiers ● After an individual has a manic episode with psychotic features, subsequent manic episodes are more likely to include psychotic features ● Incomplete interepisode recovery is more common when the current episode is accompanied by mood-incongruent psychotic features DIAGNOSTIC ISSUES Culture 2