BIPOLAR DISORDERS

Bipolar disorder is a chronic mood disorder characterized by the presence of mania (bipolar I disorder) or hypomania and depression (bipolar II disorder). Manic episodes are distinct periods of abnormally and persistent moods that can be euphoric, expansive, or irritable.

Ref: Textbook of Family Medicine: Expert Consult – Online and Print By Robert E Rakel, M.D., David Rakel, 2011, Page 1064.

Ans. A. 1 week

A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) is the minimum time for the diagnosis for manic illness, according to DSM-IV-TR criteria. 

• Inflated self-esteem or grandiosity
• Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
• More talkative than usual or pressure to keep talking
• Flight of ideas or subjective experience that thoughts are racing
• Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
• 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., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

Ans:B -Chromosome 13

A genome-wide search for susceptibility genes in bipolar disorder has yielded a potential hotspot on chromosome 22.

In addition to the chromosome 22 region, researchers found evidence of susceptibility genes for bipolar disorder on chromosomes 3, 5, 10, 13 and 21

Ans:B-Depression alone

There are three main symptoms that can occur with bipolar disorder: mania, hypomania, and depression.

While bipolar disorder can cause you to feel depressed, it’s not the same as the condition called depression. Bipolar disorder can cause highs and lows, but depression causes moods and emotions that are always “down”.

Ans:C i.e. Hypomania & Major Depression

• Bipolar 2 disorder involves a major depressive episode lasting at least two weeks and at least one hypomanic episode (a period that’s less severe than a full-blown manic episode).
• People with bipolar 2 typically don’t experience manic episodes intense enough to require hospitalization.
• Depressive symptoms include sadness or hopelessness.
• Hypomanic symptoms include a persistently elevated or irritable mood.
• Treatment includes counselling and medication, such as mood stabilisers.

Ans:D-Major depression & hypomania 

Is a less severe type of bipolar disorder characterised by depressive and hypomanic episodes.

It involves at least one depressive episode lasting at least two weeks and at least one hypomanic episode lasting at least four days.

Depressive symptoms include sadness or hopelessness. Hypomanic symptoms include a persistently elevated or irritable mood.

Ans:D-Repetitive depression & hypomania

Ans:A >> B – Hypomenia >> Cyclothymia

• Bipolar disorder (or manic-depressive psychosis = MDP) encompasses recurrent manic episodes, or recurrent episodes ofsevere (major) depression and mania (Bipolar I = BPI)/ hypomania (Bipolar II = BP II). In the intervening period the patient is normal.
• The patients with depression alone are not included in bipolar disorder. Patients who are afflicted only with major depressive episodes are said to have – major depressive disorder or unipolar depression.
• Patients with both manic and depressive episodes or patient with manic episodes alone are said to have bipolar disorder. The term unipolar mania, pure mania, or euphoric mania are sometimes used for bipolar patients who do not have depressive episodes.

Bipolar disorders (i.e. disorder with 2 poles) can be conceptualized into 3 entities :

1) Bipolar I disorder, consisting of episodes of mania cycling with depessive episodes;

2) Bipolar II disorder, consisting of episodes of hypomania cycling with depressive episodes; and

3) Cyclothymic disorder, consisting of hypomania and less severe (sub syndromal) episodes of depression. Very few patients have only manic episodes (but not includes only depression).

Ans.A- Mood disorder

• Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). 
• Bipolar disorder is a category that includes three different conditions — bipolar I, bipolar II and cyclothymic disorder.
• People with bipolar disorders have extreme and intense emotional states that occur at distinct times, called mood episodes. These mood episodes are categorized as manic, hypomanic or depressive.

Ans:D-Narcissistic

Symptoms of Narcissistic personality disorder can be confused with manic phase of bipolar disorder”.

Narcissistic personality disorder

• Narcissistic patients are grandiose and require admiration from other.
• This is characterized by Ideas of grandiosity & inflated sense of self importance; lack of empathy with others; attention seeking behavior; exploitation of others; and an arrogant, haughty attitude.