|Bipolar disorders

Question 1

definition of bipolar disorders

Answer 1

Characterised by recurrent episodes of altered mood and activity, involving both upswings and downswings.
Individual episodes are classified as:
Depressive
Manic
Hypomanic (less severe and without psychotic symptoms)
Mixed

Question 2

icd-10 definition

Answer 2

Bipolar affective disorder is defined as at least two episodes , including at least one hypomanic or manic episode

Question 3

differentials for bipolar

Answer 3

• Hyperthyroidism or hypothyroidism.
• Anorexia nervosa.
• Cerebrovascular event.
• Dementia.
• Other psychiatric disorders, eg schizophrenia.
• Acute drug withdrawal or illicit drug ingestion.

Question 4

manic phase features

Answer 4

Mania is characterised by elevated mood and increase in quantity and speed of physical and mental activity. Self-important views and ideas are greatly exaggerated. Some patients may be excessively happy, whilst others may be irritable and easily angered.
•	Grandiose ideas.
•	Pressure of speech.
•	Excessive amounts of energy.
•	Racing thoughts and flight of ideas.
•	Overactivity.
•	Needing little sleep or an altered sleep pattern.
•	Easily distracted - starting many activities and leaving them unfinished.
•	Bright clothes or unkempt.
•	Increased appetite.
•	Sexual disinhibition.
•	Recklessness with money.

Question 5

depression diagnostics (ICD-10)

Answer 5

3 core symptoms, at leas two must be present every day for at least two weeks:
1.	Low mood
2.	Anhedonia (loss of enjoyment in formerly pleasurable activities)
3.	Decreased energy
Other symtoms:
1.	↓ concentration &attention 
2.	↓self-esteem and confidence
3.	Ideas of guilt and worthlessness
4.	Feelings of hopelessness regarding the future
5.	Thoughts of dself harm
6.	↓sleep and/or appetite
Severity depends on:
1.	 Number of symptoms
2.	Degree of associated distress
3.	Interference with daily activities