况利《精神病学教学》3.1bipola disoders-huhua.pdfVIP

Mood disorders Definition  Bipolar affective disorder used to be called manic depressive psychosis. It is a disorder characterized by episodes of major depression and, at other times, mania, where mood is abnormally elated.  Between episodes, the person returns to their normal self, usually with good insight into the previous episode.病程.ppt  Type of Bipolar disorder  Bipolar (affective) disorder is mainly divided into Bipolar Ⅰdisorder and Bipolar Ⅱdisorder.  Biopolar Ⅰdisorder Consisting of episodes of mania cycling with depressive episode  Biopolar Ⅱdisorder  Consisting of episodes of hypomania cycling with major depressive episode Epidemiology  Bipolar disorder has a lifetime prevalence of about 1-2%.  with men and women equally affected.  Mean age at first onset is in the twenties, although the first episode is occasionally in late life.  After a first manic episode, the risk of recurrence is about 70%. Causes --Predisposing factors  Bipolar disorder has a strong genetic component. A family history of bipolar disorder and major depression is common.  The concordance rate in monozygotic twins is approximately 50% ,20% in dizygotic and it rises to 80% if major depression in the co-twin is counted as well as bipolar disorders. causes –Precipitating factors  Stressful life events are important in triggering both manic and depressive episodes.  Childbirth can be a precipitant.  Street drug (narcotics)use, including cannabis(大麻), heroin  Sometimes a first manic episode can be triggered by antidepressant drug treatment or the use of drugs such as steroids(prednisone). Symptoms-- manic episode (mania) 1. Mood: Elated, sometimes irritable 1.1Elationpicture1.ppt is an affective state of joyous gaiety which is out of keeping with life circumstances. It often present infectious g