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BIPOLAR DISORDER
Bipolar disorder is a common mood disorder. There is pathology
of mood, which it can be increase (mania) or decrease
(depression), that cant be controlled and cause marked
impairment in social and occupational function.
Bipolar II disorder
Presence of major depressive and hypomanic episode. There
has never been a manic or mixed episode.,
Cyclothymic disorder :
Presence of numerous periods with hypomanic symptoms, and
numerous period with depressive symptoms that do not meet
criteria for a major depressive episodes. For at least 2 years.
a. Biologic factor :
interaction between neurotranmitter systems, involving NE,
dopamine & serotonine.
b. Genetic factor :
Subsyndromal
Recurrence
Mania mania
(mania)
(hypomania)
Remission
Subsyndromal
Depression Depression
Hypomanic :
Milder than manic.
Rapid cycling :
4 mood episodes yearly
3 times women > men
Ultra rapid cycling :
4 episodes monthly
Mixed episodes :
Simultaneous symptoms of depression and mania.
Evidence up to 30 40% of all bipolar I patients.
Women > Men
Prognosis
1. Hospitalization :
If there is emergency condition ( suicide, homicide )
- Agitation condition
- Bad physical condition
- To make accurate diagnosis.
2. Pharmacotherapy :
- Mood stabilizers ( eg : lithium, carbamazepine, valproate )
- Atypical antipsychotics.
3. Psychotherapy :
- In order to support patients to overcome or adaptation to their
life problems, which the problems can become a precipitating
factor of relapse/recurrence.
- Cognitive behaviour therapy can be choosen.
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