BipolarDisorderinDSM-IV-CenterforAddictions双相情感障碍在DSM-IV中心为成瘾.pptVIP

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BipolarDisorderinDSM-IV-CenterforAddictions双相情感障碍在DSM-IV中心为成瘾.ppt

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BipolarDisorderinDSM-IV-CenterforAddictions双相情感障碍在DSM-IV中心为成瘾

Bipolar Disorder in DSM-IV Bipolar I disorder: manic episode(s)or mixed episode(s) plus MDE(s) Bipolar II disorder: major depressive episode(s) plus hypomanic episode(s) Cyclothymia: hypomanic symptomsplus depressive symptoms Bipolar Disorders: DSM-IV Nosology Manic Episode: Diagnostic Criteria Elevated, expansive, or irritable mood for 1 week or longer, plus 3 or more of the following Inflated self-esteem or grandiosity Decreased need for sleep Pressured speech Racing thoughts/flight of ideas Distractibility Psychomotor agitation/increased goal-directed activity Excessive involvement in high-risk activities Manic Episode: Differential Diagnoses Differential diagnosis Consider if . . . Manic Episode: Differential Diagnoses (cont.) Differential diagnosis Consider if . . . Major Depressive Episode: DSM-IV Criteria Depressed mood and/or loss of interest or pleasure ? 2 weeks duration Associated symptoms Physical: insomnia/hypersomnia, appetite/weight change, decreased energy, psychomotor change Psychological: feelings of guilt or worthlessness, poor concentration/indecisiveness, thoughts of death/suicidal intentions (SI) Physical Sleep disorder Appetite change Fatigue Psychomotor retardation Psychological Low self esteem/guilt Poor concentration/indecisiveness Thoughts of death/SI Mixed Episode: Diagnostic Criteria Criteria met for both manic episode + MDE for ?1 week Symptoms Are sufficient to impair functioning or Necessitate hospitalization or Are accompanied by psychotic features Bipolar Disorders: Epidemiology Bipolar Disorders: Epidemiology Recurrent in 90% of cases First-degree relatives have increased rates of BPD I, BPD II, and MDD Hypomanic episodes in BPD II immediately precede or follow MDEs in 60% to 70% of cases First-degree relatives may have increased rates of BPD I, BPD II, and MDD Epidemiology Peak age of onset: adolescence through early 20s Onset of first manic episode after age 40 years is “red flag” to consider substance us