MH701 REVIEW 2026 COMPREHENSIVE
EXAMINATION SET UPDATED 100%
CORRECT.
◉ What are comorbidities associated with bipolar disorder? Answer:
Anxiety Disorders-Greater than 50% lifetime comorbidity of anxiety
disorders with bipolar illness and these patients appear to have a more
difficult course of illness.
Decreased likelihood of recovery
Poorer role functioning and quality of life
Increased risk of suicide attempts
Substance-use disorders-61% of patients with Bipolar I and 49% of
patients with Bipolar II also have coexisting substance-use disorders
(most commonly etoh).
Personality Disorders-One-third of patients with bipolar disorder also
have a **cluster B (borderline, narcissistic, antisocial, and histrionic)
personality disorder.
◉ What is the cause of bipolar disorder? Answer: Exact cause of bipolar
disorder is not known.
,Kindling Theory is the predominant theory - multiple factors that
potentially interact and lower the threshold at which mood changes
occur. Eventually, a mood episode can start itself and become recurrent.
Recurrent mood episodes are associated with repeated physiological
insults that add up and kindle, like a spark bursting into fire. This could
compromise endogenous compensatory mechanisms, leading to cell
apoptosis that in turn causes rewiring of the brain circuits involved in
mood regulation and cognition. This can render one more vulnerable to
the effects of stressors, increasing risk of future episodes and thus
perpetuating the vicious spiral
◉ Do genetics affect bipolar? Answer: Genetics - studies show identical
twins are far more concordant for mood disorders than fraternal twins.
Overall heritability of bipolar spectrum disorders has been put at 0.71.
Between 4% - 24% of first-degree relatives of individuals with bipolar I
disorder are also diagnosed with bipolar I disorder.
◉ What are neurol process/physiological causes of bipolar? Answer:
Hypersensitivity of melatonin receptors
Structural abnormalities in the amygdala, hippocampus, and prefrontal
cortex
Larger lateral ventricles
,◉ Environmental factors in bipolar disorder. Answer: Sleep deprivation
= trigger mania
Hypersomnia = trigger MDE
Traumatic and/or abusive events in childhood
Potential that those with diurnal pattern are affected mostly by both
fluctuating light and temperature.
◉ What is Kindling Theory? Answer: An etiologic theory of bipolar
disorder that is based on the idea that a stressful situation leads to the
first bipolar episode, whether it is manic or depressive. As the disorder
progresses, further episodes may occur without any outside triggers.
◉ What 2 neurotransmitters implicated in bipolar disorder? Answer: Of
the biogenic amines, norepinephrine (NE) and serotonin (SE) are the two
neurotransmitters most implicated in the pathophysiology of mood
disorders.
◉ What are 3 treatment goals of bipolar? Answer: First, the patient's
SAFETY must be guaranteed.
Second, a complete diagnostic evaluation of the patient is necessary.
, Third, a treatment plan that addresses not only the immediate symptoms
but also the patient's prospective well-being should be initiated.
◉ What is the first line treatment for biploar? Answer: Mood stabilizers
are identified as first line.
Lithium is recommended for suicidal ideation.
Risk of suicide is reduced 13-fold with long-term maintenance therapy
with lithium.
◉ Drugs approved for bipolar depression. Answer: Quetiapine (SGA),
olanzapine-fluoxetine (SGA- SSRI), and lurasidone (SGA) have all
demonstrated consistent efficacy in bipolar depression and are approved
for this stage of the disorder.
◉ What is the drug preferred for rapid cycling? Answer: Depakote is
preferred for rapid-cycling disorders
◉ Waht medications are best for ACUTE MANIA? Answer:
**Lithium**,
**Valproate**
Carbamazepine/Oxcarbazepine, Clonazepam/Lorazepam,
EXAMINATION SET UPDATED 100%
CORRECT.
◉ What are comorbidities associated with bipolar disorder? Answer:
Anxiety Disorders-Greater than 50% lifetime comorbidity of anxiety
disorders with bipolar illness and these patients appear to have a more
difficult course of illness.
Decreased likelihood of recovery
Poorer role functioning and quality of life
Increased risk of suicide attempts
Substance-use disorders-61% of patients with Bipolar I and 49% of
patients with Bipolar II also have coexisting substance-use disorders
(most commonly etoh).
Personality Disorders-One-third of patients with bipolar disorder also
have a **cluster B (borderline, narcissistic, antisocial, and histrionic)
personality disorder.
◉ What is the cause of bipolar disorder? Answer: Exact cause of bipolar
disorder is not known.
,Kindling Theory is the predominant theory - multiple factors that
potentially interact and lower the threshold at which mood changes
occur. Eventually, a mood episode can start itself and become recurrent.
Recurrent mood episodes are associated with repeated physiological
insults that add up and kindle, like a spark bursting into fire. This could
compromise endogenous compensatory mechanisms, leading to cell
apoptosis that in turn causes rewiring of the brain circuits involved in
mood regulation and cognition. This can render one more vulnerable to
the effects of stressors, increasing risk of future episodes and thus
perpetuating the vicious spiral
◉ Do genetics affect bipolar? Answer: Genetics - studies show identical
twins are far more concordant for mood disorders than fraternal twins.
Overall heritability of bipolar spectrum disorders has been put at 0.71.
Between 4% - 24% of first-degree relatives of individuals with bipolar I
disorder are also diagnosed with bipolar I disorder.
◉ What are neurol process/physiological causes of bipolar? Answer:
Hypersensitivity of melatonin receptors
Structural abnormalities in the amygdala, hippocampus, and prefrontal
cortex
Larger lateral ventricles
,◉ Environmental factors in bipolar disorder. Answer: Sleep deprivation
= trigger mania
Hypersomnia = trigger MDE
Traumatic and/or abusive events in childhood
Potential that those with diurnal pattern are affected mostly by both
fluctuating light and temperature.
◉ What is Kindling Theory? Answer: An etiologic theory of bipolar
disorder that is based on the idea that a stressful situation leads to the
first bipolar episode, whether it is manic or depressive. As the disorder
progresses, further episodes may occur without any outside triggers.
◉ What 2 neurotransmitters implicated in bipolar disorder? Answer: Of
the biogenic amines, norepinephrine (NE) and serotonin (SE) are the two
neurotransmitters most implicated in the pathophysiology of mood
disorders.
◉ What are 3 treatment goals of bipolar? Answer: First, the patient's
SAFETY must be guaranteed.
Second, a complete diagnostic evaluation of the patient is necessary.
, Third, a treatment plan that addresses not only the immediate symptoms
but also the patient's prospective well-being should be initiated.
◉ What is the first line treatment for biploar? Answer: Mood stabilizers
are identified as first line.
Lithium is recommended for suicidal ideation.
Risk of suicide is reduced 13-fold with long-term maintenance therapy
with lithium.
◉ Drugs approved for bipolar depression. Answer: Quetiapine (SGA),
olanzapine-fluoxetine (SGA- SSRI), and lurasidone (SGA) have all
demonstrated consistent efficacy in bipolar depression and are approved
for this stage of the disorder.
◉ What is the drug preferred for rapid cycling? Answer: Depakote is
preferred for rapid-cycling disorders
◉ Waht medications are best for ACUTE MANIA? Answer:
**Lithium**,
**Valproate**
Carbamazepine/Oxcarbazepine, Clonazepam/Lorazepam,
