Bipolar Disorder

Basics

Mania:
- Presentation is diverse and may be difficult to recognize as mania:
  - Simple irritability
  - Cheerfulness
  - Psychosis
  - Delirium
  - Agitation
- Full extent of pathology often revealed only by outside informants
- Onset gradual or acute, duration several weeks or months; rarely may be chronic
Hypomania:
- Milder symptoms without marked impairment
Mixed mood:
- Simultaneous symptoms of mania and depression
- Treat in ED as for mania
Bipolar disorder:
- Formerly manic depressive disorder
- Defined as one or more episodes of hypomanic, manic, or mixed mood
- Possibly with episodes of depressed mood
- Bipolar II is used to denote cases where hypomania has occurred in the course of the disorder but never mania
- Typically begins in the teens or 20s
- Episodes of abnormal mood may be mild or severe, brief or prolonged, infrequent or chronic, chiefly elevated or chiefly depressed in character
- Bipolar disorder may be readily responsive to treatment or nearly intractable
Schizoaffective disorder:
- Characterized by episodes of altered mood, but psychotic features present even when mood is normal

Typically, a primary psychiatric disorder, with genetic association
May be secondary to medical disorder (e.g., drug toxicity, endocrine, neurologic process)
Particularly likely to be secondary if:
- First episode
- Patient >40 yr
- Atypical or mixed presentation
- Abnormal sensorium

There's more to see -- the rest of this topic is available only to subscribers.