Tag: Bipolar Disorders

Bipolar Disorders

BIPOLAR DISORDERS

Q. 1

All of the following conditions on it’s own can be considered for the diagnosis of Bipolar disorder, EXCEPT:

 A

Hypomania

 B

Depression

 C

Mania and Depression

 D

Mixed Affective State

Q. 1

All of the following conditions on it’s own can be considered for the diagnosis of Bipolar disorder, EXCEPT:

 A

Hypomania

 B

Depression

 C

Mania and Depression

 D

Mixed Affective State

Ans. B

Explanation:

Either mania or hypomania are required for a diagnosis of Bipolar Affective Disorder. 
 
Bipolar 1 – Mania and Depression
Bipolar 2 – Hypomania (mild mania) and Depression
Bipolar 3 – Anti-depressant induced Mania or Hypomania
Mixed affective States: Both Mania and Depressive symptoms coexist
Rapid Cycling Bipolar: 4 or more mood cycles in a years time.
 
As a rule most of the times mania or hypomania will be followed by depression. However in unipolar depression, mania is not a feature.  
 
Ref: Kaplan & Sadock’s Synopsis of Psychiatry 9th Edition, Page 542,534-60; Harrison’s Principles of Internal Medicine 16th Edition, Page 2556; A short textbook of Psychiatry by Neraj Ahuja 5th Edition, Page74; Current Diagnosis & Treatment In Psychiatry Page 312-322; Shorter Oxford Textbook of Psychiatry, 5th Edition, Page 227, 247-251

Q. 2

Which of the following is the characteristic feature of Bipolar disorder II?

 A

Hypomania plus mania

 B

Depression alone

 C

Mania and depression

 D

Hypomania and depression

Q. 2

Which of the following is the characteristic feature of Bipolar disorder II?

 A

Hypomania plus mania

 B

Depression alone

 C

Mania and depression

 D

Hypomania and depression

Ans. D

Explanation:

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.


Q. 3

According to DSM IV, Mania of Bipolar Disorder will fulfil the diagnostic criteria if the symptoms persist for what period of time in a young lady who is not hospitalised?

 A

1 week

 B

2 week

 C

3 week

 D

4 week

Q. 3

According to DSM IV, Mania of Bipolar Disorder will fulfil the diagnostic criteria if the symptoms persist for what period of time in a young lady who is not hospitalised?

 A

1 week

 B

2 week

 C

3 week

 D

4 week

Ans. A

Explanation:

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. 

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 (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)

Quiz In Between


Q. 4

Chromosome associated with bipolar disease‑

 A

Chromosomel6

 B

Chromosome 13

 C

Chromosome 14

 D

Chromosome 11

Q. 4

Chromosome associated with bipolar disease‑

 A

Chromosomel6

 B

Chromosome 13

 C

Chromosome 14

 D

Chromosome 11

Ans. B

Explanation:

B i.e. Chromosome 13


Q. 5

All of the following are included in diagnosis of Bipolar disorder except:

 A

Mania alone

 B

Depression alone

 C

Mania and depression

 D

Mania and anxiety

Q. 5

All of the following are included in diagnosis of Bipolar disorder except:

 A

Mania alone

 B

Depression alone

 C

Mania and depression

 D

Mania and anxiety

Ans. B

Explanation:

B i.e. Depression alone


Q. 6

Bipolar type II disorder includes combination of

 A

Hypomania & dysthymia

 B

Hypomania & subsyndromal depression

 C

Hypomania & subsyndromal depression

 D

Mania & subsyndromal depression

Q. 6

Bipolar type II disorder includes combination of

 A

Hypomania & dysthymia

 B

Hypomania & subsyndromal depression

 C

Hypomania & subsyndromal depression

 D

Mania & subsyndromal depression

Ans. C

Explanation:

C i.e. Hypomania & Depression

Quiz In Between


Q. 7

Bipolar II disorder includes

 A

Cyclothymic disorder

 B

Dysthemia

 C

Single manic episode

 D

Major depression & hypomania

Q. 7

Bipolar II disorder includes

 A

Cyclothymic disorder

 B

Dysthemia

 C

Single manic episode

 D

Major depression & hypomania

Ans. D

Explanation:

D i.e. Major depression & hypomania


Q. 8

True about bipolar disorder type II is-

 A

Recurrent depression

 B

Recurrent mania

 C

Repetitive depression & mania

 D

Repetitive depression & hypomania

Q. 8

True about bipolar disorder type II is-

 A

Recurrent depression

 B

Recurrent mania

 C

Repetitive depression & mania

 D

Repetitive depression & hypomania

Ans. D

Explanation:

D i.e. Repetitive depression & hypomania


Q. 9

Which of the following is/are included in bipolar disease:

 A

Hypomania

 B

Cyclothymia

 C

Paranoid disorder

 D

A & B

Q. 9

Which of the following is/are included in bipolar disease:

 A

Hypomania

 B

Cyclothymia

 C

Paranoid disorder

 D

A & B

Ans. D

Explanation:

A >> B i.e. Hypomenia >> Cyclothymia

–  Bipolar disorder (or manic-depressive psychosis = MDP) encompasses recurrent manic episodedsQ, or recurrent episodes ofsevere (major) depression and mania (Bipolar I = BPI)/ hypomania (Bipolar II = BP II)Q. In the intervening period the patient is normalQ.

–  The patients with depression alone are not included in bipolar disorderQ. Patients who are afflicted only with major depressive episodesQ 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 episodesQ (but not includes only depression).

Quiz In Between


Q. 10

Bipolar disorder is a:     

TN 11

 A

Mood disorder

 B

Neurotic disorder

 C

Behavior disorder

 D

Personality disorder

Q. 10

Bipolar disorder is a:     

TN 11

 A

Mood disorder

 B

Neurotic disorder

 C

Behavior disorder

 D

Personality disorder

Ans. A

Explanation:

Ans. Mood disorder


Q. 11

Personality associated bipolar disorder –

 A

Antisocial

 B

Anakastic

 C

Borderline

 D

Narcissistic

Q. 11

Personality associated bipolar disorder –

 A

Antisocial

 B

Anakastic

 C

Borderline

 D

Narcissistic

Ans. D

Explanation:

Ans. is ‘d’ i.e., 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.

Quiz In Between



Bipolar Disorders

BIPOLAR DISORDERS


BIPOLAR DISORDERS

  • Characterized by episodes of both mania & depression.
  • Equally prevalent in men & women.
    • Manic episodes – More common in men; depressive episodes – More common in women.
    • More commonly seen in divorced and single persons.
  • Onset age – 30 yrs (average). 
Causes:

Neurotransmitters:

  • Increased dopamine levels for manic episode.

Genetic factors:

  • Chromosomes 18q & 22q – Strongest evidence linked to bipolar disorder.
  • Chromosome 21q involved.

Subtypes:

  • Bipolar 1/2 = Schizobipolar disorder (schizoaffective disorder)
  • Bipolar I = Mania with depression (or mania alone).
    • Bipolar I 1/2 = Depression with protracted hypomania.
  • Bipolar ll = Depression with discrete hypomanic episodes.
    • Bipolar ll 1/2 = Depression superimposed on cyclothymia.
  • Bipolar lll = Depression plus induced hypomania 
    • (e.g. hypomania occurring solely in association with antidepressants or other somatic treatment.
    • Bipolar lll 1/2 = Bipolar disorder associated with substance use
  • Bipolar lV = Depression superimposed on hyperthymic temperament.

Symptoms:

Symptoms of manic episode:

  • Elevated mood – Undue happiness or irritable mood.
  • Increased self-esteem or grandiosity.
  • Decreased need for sleep (e.g. patient feels rested after 2 hours of sleep)
  • Over-talkativeness.
  • Flight of ideas.
  • Distractibility (not able to concentrate on task in hand).
  • Increased goal-directed activities (overactivity, hypersexuality overfamiliarity).
  • Psychomotor agitation.

Diagnostic criteria:

  • Symptoms should last for at least 7 days.
  • Must cause marked impairment in social & occupational functioning.

Psychotic symptoms:

  • Delusions & hallucination.
  • Maybe mood congruent (delusion of grandiosity)/incongruent (delusion of persecution).

Diagnostic criteria:

  • Must exhibit manic episode with psychotic symptoms.

Hypomania:

  • Symptoms similar to mania with lesser severity & reduced social & occupational functioning impairment.
  • Duration criterion = 4 days.

Mixed episodes:

  • Presents with both manic & depressive symptoms.
  • Duration = Min. 7 days.

TREATMENT:

  • Mood stabilizer: Lithium (prototyplcal mood stabilizer), valproate, carbamazepine, oxcarbazepine & lamotrigine (For bipolar depression).
  • Antipsychotics.
  • Benzodiazepines (lorazepam & clonazepam) – Used in acute mania due to their calming effect.
  • Antidepressants – Only as combination drug.

Exam Important

  • Chromosomes 18q & 22q have strongest evidence linked to bipolar disorder.
  • Symptoms of manic episode includes distractibility, flight of ideas & decreased need for sleep.
  • Diagnostic criteria for manic episode is that symptoms should last for at least 7 days.
  • Lithium is considered “prototypical mood stabilizer”.
Don’t Forget to Solve all the previous Year Question asked on BIPOLAR DISORDERS

Module Below Start Quiz

Malcare WordPress Security