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Medicine Notes Clinical Psychiatry Notes

Bipolar Affective Disorder Notes

Updated Bipolar Affective Disorder Notes

Clinical Psychiatry Notes

Clinical Psychiatry

Approximately 47 pages

This series of notes is on psychiatry. It includes psychiatry basics, treatments and complications. Each disease is separated into a different document, with it's own classification. These notes were made using a variety of textbooks, notes from tutorials with consultants and knowledge gained on the ward with doctors. These notes helped me a achieve a good grade of 78% in the end of year exams....

The following is a more accessible plain text extract of the PDF sample above, taken from our Clinical Psychiatry Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Bipolar Affective Disorder (BPAD)

  • Categories

    • Type 1

      • Mood swings across mood scale (both mania and depression)

      • Untreated

        • Mania= 3-6 months

        • Depressive= 6-12 months

    • Type 2

      • Prevalence of depression

      • >1 severe depression

      • Hypomania (6-8 on scale) rather than extreme manic episode

    • Rapid cycling BPAD

      • Mood swings change faster

      • 4 in year

      • Can happen in T1 & T2

  • Epidemiology

    • Lifetime prevalence 1%

    • M 1:1 F

    • Mean age= 21

  • Aetiology

    • Genetics

    • Neurochemical abnormalities

    • Life events/Environmental factors

    • Organic causes

  • Features of Mania

    • Period of elevated/expansive/irritable mood (>1week)

    • 3/4 of these are present

      • Inflated self-esteem

      • Distractibility

      • More talkative/Pressure to talk

      • Flight of ideas/Subjective thoughts racing

      • Increase in goal directed activities or psychomotor activities

      • Pleasurable activities that can have painful consequences

      • Decrease need sleep

    • Other features

      • Social & occupation functioning impaired

      • Psychotic symptoms

      • Hospitalisation

  • DDx

    • Organic causes

    • Schizoaffective disorders

    • Cyclothymia

    • Puerperal disorders

  • Treatment

    • Antipsychotics [OLANZIPINE/RISPERIDONE/HALOPERIDOL]

    • Benzodiazepines (ST)

    • Mood stabilisers [LITHIUM; CARABAZEPINE; VALPROATE; LAMOTRIGINE]

    • ECT [Rapid/ST improvement; Severe; Others ineffective

    • Long-term (if risk; T1->2 acute episodes; T2 effecting function; Suicide)

      • [LITHIUM; OLANZIPINE; VALPROATE]

Depression

  • Epidemiology

    • Lifetime 10-20%

    • Mean age= 27

    • M 1:2 F

    • Co-morbid w/ anxiety & substance abuse

  • Aetiology

    • Genetics

    • Neurological

      • low 5HT/Tryptophan

      • Low DA metabolism

      • Low NA

      • HPA axis- High cortisol

    • Psychological- negative beliefs

    • Environmental- Parental; Relationships; Life events; Poverty

    • Personality- OCD; Histrionic

    • Physical- Chronic pain; Hypothyroid; MS; PD; Stroke; Hyperparathyroidism; Cushing's

    • Medications- Anti-HTN; Steroids; Sedatives; Chemo; Antipsychotics

    • Life events

  • Clinical...

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