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A. A distinct period of abnormally and persistently elevated, Main differences between manic and hypomanic:
expansive, or irritable mood, lasting at least 1 week (or any Manic Hypomanic
duration if hospitalization is necessary) Duration 1 week 4 days
B. During the period of mood disturbance, three or more of Symptom severity
the following symptoms have persisted (four of the mood Functioning affected not affected
is only irritable) and have been present to a significant Psychotic features -
degree:
i. inflated self-esteem or grandiosity
MIXED EPISODE
feeling niya bidang bida siya, walang magaling kundi
sarili niya. siya lang ang tama – over confident
ii. decreased need for sleep (eg. feels rested after only 3 DSM-IV-TR Diagnostic Criteria for Mixed Episode
hours of sleep)
A. The criteria are met for a manic episode and for a major
iii. more talkative than usual or pressure to keep talking
depressive episode (except for duration) nearly every day
during at least 1 week.
B. The mood disturbance is sufficiently secere 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 SUMMARY
others, or there are psychotic features.
C. The symptoms are not due to the direct physiological Episode Disorder
effects of a substance (eg. a drug of abuse, a medication) or Major depressive Major depressive
a general medical condition (eg. hyperthyroidism). episode disorder; single
Maniclike episodes that are clearly caused by somatic
antidepressant tretment (medication, electroconvulsive episode
therapy, light therapy) should not count count toward a Major depressive Major depressive
diagnosis of bipolar I disorder.
episode + major disorder; recurrent
CYCLOTHYMIC EPISODE depressive episode
DSM-IV-TR Diagnostic Criteria for Cyclothymic Episode
Major depressive Manic-depressive
episode + manic/mixed disorder Type I/Bipolar
A. For at least 2 years, the presence of numerous periods
with hypomanic symptoms and numerous periods with
episode I
depressive symptoms that do not meet criteria for a major Manic/mixed Manic-depressive
depressive episode. In children and adolescents, the duration disorder Type I/Bipolar
must be at least 1 year.
B. During the above 2-year period, the person has not been I
without symptoms for more than 2 months. Major depressive Manic-depressive
C. No major depressive episode, manic episode, or mixed episode + hypomanic disorder Type
episode has been present during the first two years of the
disturbance. episode II/Bipolar II
D. The symptoms are not better accounted for by Chronic subsyndromal Dysthymic disorder
schizoaffective disorder and are not superimposed on depression
schizophrenia, schizophreniform disorder, delusional
disorder, or psychotic disorder not otherwise specified. Chronic fluctuation Cyclothymic disorder
E. The esymptomscause marked impairment in occupational, between subsyndromal
social, or other important areas of functioning. depression &
F. The symptoms are not due to the direct physiological
effects of a substance (eg. a drug of abuse, a medication) or hypomania
a general medical condition (eg. hyperthyroidism).
RAPID CYCLING
SAMPLE QUIZ
DSM-IV-TR Diagnostic Criteria for Rapid-cycling Specifier ___1. DSM-IV-TR diagnostic criteria for manic episode include the ff:
a. duration of at least 4 days
A. With rapid cycling (can be applied to bipolar I disorder or b. symtoms are not severe enough to cause impairment in
bipolar II disorder) social or occupational functioning
B. At least 4 episodes of a mood disturbance in the previous c. elevated, expansive, or irritable mood
d. all of the above
12 months that meet criteria for a major depressive,
___2. Neurotransmitter commonly associated with depression
manic, mixed, or hypomanic episode. a. dopamine c. GABA
b. norepinephrine d. serotonin
COMPARISON OF THE 5 BIPOLAR DISORDERS: ___3. which of the ff. is a trucyclic antidepressant
Epidemiology_ a. venlafaxine c. fluoxetine
b. imipramine d. mirtazapine
Bipolar I is less common than MDD ___4. Which of the ff. factors would mean a poor prognosis for a
lifetime prevalence: Bipolar I patient?
Bipolar I 0.4 – 1.6 % a. female gender c. few suicidal thoughts
Bipolar II 0.5 % b. advanced age of onset d. depressive features
Cyclothymic 0.4 – 1.0 % ___5. Effective blood level range of lithium
a. 0.4 – 0.8 mEq/L c. 1.2 – 1.6 mEq/L
Rapid Cycling 5 – 15 % b. 1.5 – 1.2 mEq/L d. 1.6 – 2.0 mEq/L
gender prevalence ___6. According to thr depression guideline panel, which of the ff. is a
Bipolar I M=F risk factor for depression?
MDD M<F a. comorbid medical illness c. no prior hx of depression
Manic episode M>F b. onset after 40y d. all of the above
___7. life event most associated with depression
Rapid Cycling M<F a. losing a parent after 11y
when manic episodes occur in women, more likely it b. losing a spouse bedore 40y
is of the mixed type c. losing a parent before 11y
d. losing a sibling after 7y
___8. Criteria for rapid cycling Bipolar I
a. 2episodes in 12months c. 2episodes in 6months
b. 4episodes in 12months d. 4 episodes in 6 months
___9. most common mood disorder reported
a. MDD
b. Bipolar disorder
c. Dysthymic disorder
d. Cyclothymic disorder
___10. If MDD and Hypomanic episode is present, diagnosis?
a. Cyclothymic disorder
b. Mixed episode
c. Bipolar I disorder
d. Bipolar II disorder
Answers: CDBDBACBAD
SUMMARY