P&B Lecture 6 - Bipolar PDF

Week 6 - 8th Nov Created @August 10, 2024 10:00 AM Tags Current Challenges in Bipolar & CBT for Bipolar: Reading list: PSBS0005: Current Research in Psychosis and Bipolar | University College London (talis.com)...

Week 6 - 8th Nov Created @August 10, 2024 10:00 AM Tags Current Challenges in Bipolar & CBT for Bipolar: Reading list: PSBS0005: Current Research in Psychosis and Bipolar | University College London (talis.com) Location: North West Wing - G22LT Current Challenges in Bipolar: Joe Hayes Class Prep: Additional: Read: Bipolar Disorder Read: Epidemiology and Risk Factors for Bipolar Disorder Read: The Course of Bipolar Disorder Definition DSM ICD Single episode of: at least two episodes of: Hypomania OR mania mood disturbance Bipolar I = Mania occurred at least once Bipolar II = Hypomania at least once Week 6 - 8th Nov 1  Hypomania At least 3 of the following: Elevated or irritable sustained Increased activity or restlessness for at least 4 days Increased talkativeness Distractibility Decreased need for sleep Increased sexual energy Mild recklessness or irresponsible behaviour Increased sociability Leading to some interference with personal function. Mania At least 3 of the following: Predominantly elevated or Increased activity or restlessness irritable sustained for at least 1 Increased talkativeness week Flight of ideas Loss of normal social inhibitions Decreased need for sleep Inflated self-esteem or grandiosity Distractibility or constant changes in activity Leading to severe interference with Behaviour that is foolhardy or reckless personal function. Marked sexual energy or sexual indiscretions Mania with Psychotic Symptoms Week 6 - 8th Nov 2  Commonly mood congruent delusions and hallucinations Common delusional themes: grandeur (fame, omnipotence, wealth, power), persecution Common hallucinatory experiences: second person auditory hallucinations supporting delusional content Mild Depressive Episode At least 2 of A and 2 of B: Depressive mood for at least 2 weeks Moderate Depressive Episode At least 2 of A and 3 of B: Depressed mood sustained for at least 2 weeks Week 6 - 8th Nov 3  Severe Depressive Episode All of A and at least 4 of B: Depressed mood sustained for at least 2 weeks Severe Depression with Psychosis Commonly mood congruent delusions and hallucinations Depressed mood sustained for Common delusional themes: at least 2 weeks worthlessness, guilt, ill-health (hypochondrical), poverty (delusions of impoverishment), persecution Common hallucinatory experiences: Classically second person auditory hallucinations, olfactory hallucinations of rotting filth/flesh Depressive Stupor: very severe depression → person stops speaking or moving (catatonia) Cotard’s Syndrome (rare): the patient has a delusional belief that they are dead (figuratively or literally), do not exist, are putrefying, or have lost their blood or internal organs. Week 6 - 8th Nov 4  Variants of Bipolar Disorder Rapid Cycling 4 or more episodes per year 20% of cases More common in women Becomes more phasic over time (kindling effect) Cyclothymia A hx of mild hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes Low grade of cycling of mood which appears to the observer as a personality trait, and interferes with functioning Epidemiology Variable prevalence est. Worldwide Bipolar I ~ 1% Bipolar II ~ 3% Bipolar Spectrum ~ 6% UK incidence = 15/100,000 person years at risk Increasing over last 20yrs Age at onset = 15-19yrs often up to 10 yrs diagnostic delya Bipolar I → equal between M & F Bipolar II → M