1 / 20

BIPOLAR DISORDERS

BIPOLAR DISORDERS. Presented by: Chris Miller, 4 th Year Medical Student (USESOM), Psychiatry Rotation For: Dr. D. Martinez. TOPICS COVERED. Bipolar I Disorder Bipolar II Disorder Cyclothymic Disorder

duke
Download Presentation

BIPOLAR DISORDERS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. BIPOLAR DISORDERS Presented by: Chris Miller, 4th Year Medical Student (USESOM), Psychiatry Rotation For: Dr. D. Martinez

  2. TOPICS COVERED • Bipolar I Disorder • Bipolar II Disorder • Cyclothymic Disorder • The epidemiology, etiology, clinical manifestations, and management of each disorder will also be covered.

  3. BIPOLAR I DISORDER • Most serious of all bipolar disorders • Diagnosed after at least one episode of mania. • Patients also may experience major depressive episodes in the course of their lives. http://www.bipolardisorder-symptoms.net/wp-content/uploads/2010/12/bipolar-disorder-symptoms-3.jpg

  4. DIAGNOSTIC CRITERIA FOR MANIC EPISODES General criteria for a manic episode require a period of elevated, expansive, or irritable mood that lasts 1 week or requires hospitalization. A general medical condition and substance abuse must be ruled out before these symptoms are considered mania.

  5. DIFFERENTIAL DIAGNOSIS OF MANIA • May be induced by: • Antidepressant medications • Psychostimulants • Electroconvulsive therapy • Phototherapy • If the above occurs, the patient is diagnosed with substance-induced mood disorder

  6. EPIDEMIOLOGY OF BIPOLAR I DISORDER • The lifetime prevalence is 0.4% to 1.6% • The ratio of males to females affected is equal • There are no racial variations in incidence

  7. ETIOLOGY OF BIPOLAR I DISORDER • Genetic studies indicate that bipolar I disorder is associated with increased bipolar I, bipolar II, and major depressive episodes in first-degree relatives. • X-linkage has been shown in some studies but is still controversial. • Mania can be precipitated by: • Psychosocial stressors • Sleep/wake cycle changes http://img.thebody.com/legacyAssets/62/93/bipolar.gif

  8. CLINICAL MANIFESTATIONS OF BIPOLAR I DISORDER • Defined by the occurrence of a manic episode • A single manic episode is sufficient enough to meet diagnostic criteria but most patients have recurrent manic episodes mixed with depressive episodes • The 1st episode of mania usually occurs in the early 20s • Lifetime suicide rates range from 10% to 15%

  9. CLINICAL MANIFESTATIONS OF BIPOLAR I DISORDER (CONT.) • Children can also present with bipolar disorder that resembles the adult type but differs according to their age and developmental level. • Very young children may present with uncontrollable giggling. • School-age children may try to teach their grammar class in the presence of their teacher. • Adolescents may present with severe anger outbursts and agitation. • Most children with bipolar disorder have more than one relative with the same condition.

  10. MANAGEMENT OF BIPOLAR I DISORDER • The following medications can be used: • Antipsychotics • Benzodiazepines • Mood stabilizers (valproic acid, lithium) • Combination therapy is more effective than monotherapy • Some atypical antipsychotics such as clozapine, quetiapine, olanzapine, and aripiprazole can be used for maintenance • Electroconvulsive therapy can also be used for refractory cases and patients intolerant to medications.

  11. BIPOLAR II DISORDER • Bipolar II disorder is similar to bipolar I disorder except that mania is absent in bipolar II disorder. • Hypomania is the essential diagnostic finding. • Hypomania is a milder form of elevated mood than mania. http://stahlonline.cambridge.org/content/ep/images/85702c11_fig8.jpg

  12. BIPOLAR II DISORDER http://knowingbipolardisorder.com/wp-content/uploads/2009/01/bipolar-2-288x300.jpg

  13. CLINICAL MANIFESTATIONS OF BIPOLAR II DISORDER • Characterized by the occurrence of hypomania and episodes of major depression in an individual who has never met criteria for mania or a mixed state. • Hypomania is determined by the same symptom complex as mania, but the symptoms are less severe, cause less impairment, and usually do not require hospitalization. • Bipolar II is cyclic • Suicide occurs in 10% to 15% of patients (same as bipolar I)

  14. MANAGEMENT OF BIPOLAR II DISORDER • The treatment is the same as for bipolar I disorder • Hypomanic episodes do not require as aggressive a treatment as mania. http://www.themedicalguru.com/wp-content/uploads/2010/07/medicine_pills.jpg

  15. CYCLOTHYMIC DISORDER • Cyclothymic disorder is a recurrent, chronic, mild form of bipolar disorder in which mood typically oscillates between hypomania and dysthymia. • If a manic episode or depressive episode is experienced, cyclothymic disorder is not diagnosed. http://www.allaboutdepression.com/cyclothymia/images/graphic2.gif

  16. CYCLOTHYMIC DISORDER

  17. CLINICAL MANIFESTATIONS OF CYCLOTHYMIC DISORDER • Cyclothymic disorder is a milder form of bipolar disorder consisting of recurrent mood disturbances between hypomania and dysthymic mood. • A single episode of hypomania is sufficient enough to diagnose cyclothymic disorder, although most individuals also have dysthymic periods. • Cyclothymic disorder is never diagnosed when there is a history of mania, major depressive episode, or mixed episode.

  18. MANAGEMENT OF CYCLOTHYMIC DISORDER • Cyclothymic disorder can be treated with: • Psychotherapy • Mood stabilizers • Antidepressants • Patients with cyclothymic disorder may never seek medical attention for their mood symptoms http://www.cyclothymiasymptoms.com/help/images/7.jpeg

  19. CONCLUSION • Bipolar I disorder • Diagnosed by at least one manic episode and usually experiences depressive episodes • Bipolar II disorder • Hypomania with depressive episodes • Cyclothymic disorder • Cyclic disorder oscillating between hypomania and dysthymia http://www.free-press-release.com/uploads/news/2010/07/18/1279479453_img1.jpg

  20. REFERENCES • Kaplan USMLE STEP 2 CK Lecture Notes 2010, psychiatry section • http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002517/ • http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml • BluePrints Psychiatry, Lippincott Williams and Wilkins, 2009, mood disorders, pg 8 • http://en.wikipedia.org/wiki/Bipolar_disorder

More Related