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Bipolar Disorder

2. Bipolar Disorder. Bipolar disorder is an episodic, lifelong illness with a variable course. The initial episode can be manic, hypomanic, depressive, or mixed. Men are more likely than women to be initially manic, but men and women are both more likely to have their first episode be depressi

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Bipolar Disorder

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    1. Bipolar Disorder Glenda Bingham March 29, 2006

    2. 2 Bipolar Disorder Bipolar disorder is an episodic, lifelong illness with a variable course. The initial episode can be manic, hypomanic, depressive, or mixed. Men are more likely than women to be initially manic, but men and women are both more likely to have their first episode be depressive. Frequently, there will be several episodes of depression before the first manic episode occurs.

    3. 3 Bipolar Disorder Facts Lifetime prevalence Type I: 1% Type II: 4% Suicide rate: 15-20% Incidence of psychotic features: 47-75% 60 to 65 % of patients have a positive family history Overrepresentation in higher socioeconomic and educational groups Age of onset: Range 20 to 40 years Average: 20 years Preston et al., 2005

    4. 4 Causes Catecholamine theory “Permissive Hypothesis” Neuroanatomical theory Genetic theory

    5. 5 Categories of Bipolar Disorders

    6. 6 Criteria for Manic Episode A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). B. 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: inflated self-esteem or grandiosity decreased need for sleep more talkative than usual or pressure to keep talking flight of ideas or subjective experience that thoughts are racing distractibility 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., shopping sprees, gambling, sexual indiscretions, or foolish business investments)

    7. 7 Criteria for Manic Episode (cont.) The symptoms do not meet criteria for a Mixed Episode The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

    8. 8 Drugs That Can Induce Mania Stimulants (amphetamines) Antidepressants (especially tricyclic) SAM-e Antihypertensives Corticosteroids in high doses Anticholinergics Thyroid hormones

    9. 9 Medical Conditions Associated with Mania Central nervous system trauma (stroke) Metabolic disorders (hypothyroidism) Infectious diseases (encephalitis) Seizure disorders Central nervous system tumor

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