MSN 620 Final - Mental Health Exam Study Guide

MSN 620 Final - Mental Health Exam Study Guide Define bipolar disorder - Correct Answer️️ -Bipolar disorder (BD) is characterized by chronically occurring episodes of mania or hypomania alternating with depression What are the categories of bipolar disorder? - Correct Answer️️ -bipolar I disorder (BD- I) bipolar II disorder (BD-II) cyclothymic disorder other specified bipolar and related disorders bipolar or related disorders, unspecified. Describe the etiology of bipolar disorder. - Correct Answer️️ -interaction of genetic, epigenetic, neurochemical, and environmental factors. Heritability is well established. short arm of chromosome 11 childhood maltreatment, particularly emotional abuse or neglect, has been linked to the later development of the condition. Other stressful life events associated with developing BD include childbirth, divorce, unemployment, disability, and early parental loss. In adulthood, "stressful life event" came 6 months before a manic or depressive episode. TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 2/20 The etiology of BD is thought to involve imbalances in systems associated with monoaminergic neurotransmitters, particularly dopamine and serotonin, and intracellular signaling systems that regulate mood. a diffuse pattern of brain alterations including smaller subcortical volumes, lower cortical thickness and altered white matter integrity in groups of individuals with bipolar disorder compared to healthy controls When is the peak of bipolar disorder age wise? - Correct Answer️️ -There are two peaks in the age of onset: 15-24 years and 45-54 years, with more than 70% of individuals manifesting clinical characteristics of the condition before 25 years of age. Patho of bipolar disorder - Correct Answer️️ -Evidence supports a strong genetic component and an epigenetic contribution. Human studies have shown changes in brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4) in patients with BD, indicating neurotrophic signaling is a molecular mechanism associated with decreased neuroplasticity. Other proposed mechanisms include mitochondrial dysfunction, oxidative stress, immune-inflammatory imbalance, and compromised hypothalamic-pituitary-adrenal axis. Additionally, neuroimaging studies have shown "evidence of change in regional activity, functional connectivity, neuronal activity, and bioenergetics associated with BD," and anatomic studies have revealed dendritic spine loss in the dorsolateral prefrontal cortex in the post-mortem brain tissue of patients with BD. TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 3/20 What are some characteristics that can increase the likelihood of a bipolar rather than unipolar diagnosis? - Correct Answer️️ -Inquiry into past hypomanic or manic episodes is particularly important for patients with early onset of their first depressive episode (ie, in patients younger than 25 years), a high number of lifetime depressive episodes (5 or more episodes), and a family history of bipolar disorder. These findings in the patient's history have been shown to increase the likelihood of a bipolar rather than a unipolar diagnosis. Other factors increasing the likelihood of a diagnostic change from MDD to BD include the presence of psychosis, unresponsiveness to antidepressants, the induction of manic or hypomanic symptoms by antidepressant drug treatment, and polymorbidity, defined as 3 or more comorbid conditions. Describe the criteria to diagnose BD-I - Correct Answer️️ -Criteria met for at least one manic episode, which might have been preceded or followed by a hypomanic episode or major depressive episode (hypomanic or major depressive episodes are not required for the diagnosis). Describe the criteria to diagnose BD-II - Correct Answer️️ -Criteria met for at least one current or past hypomanic episode and a major depressive episode; no manic episodes. Describe the criteria to diagnose cyclothymic disorder. - Correct Answer️️ -Hypomanic symptoms that do not meet the criteria for hypomanic episodes and depressive symptoms that do not meet the criteria for major depressive episodes in TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 4/20 numerousperiods (at least half the time) for at least 2 years (1 year in those aged ≤18 years); criteria for major depressive, manic, or hypomanic episodes have never been met. Describe the criteria to diagnose specified bipolar and related disorders - Correct Answer️️ -Bipolar-like phenomena that do not meet the criteria for BD-I, BD-II, or cyclothymic disorder due to insufficient duration or severity, ie, 1) short-duration hypomanic episodes and major depressive disorder, 2) hypomanic episodes with insufficient symptoms and major depressive episode, 3) hypomanic episode without a prior major depressive episode, and 4) short-duration cyclothymia. Describe the criteria to diagnose unspecified bipolar and related disorders - Correct Answer️️ -Characteristic symptoms of bipolar and related disorders that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning but do not meet the full criteria for any category previously mentioned. Describe rapid cycling. - Correct Answer️️ -BD-I and BD-II can be further specified as rapid cycling or seasonal pattern and whether the episodes have psychotic features, catatonia, anxious distress, melancholic features, or peripartum onset. Rapid cycling refers to 4 or more distinct mood episodes during a 12-month period. Describe mood-congruent delusions. - Correct Answer️️ -Mood-congruent delusions may be present in either a depressive or manic episode, including delusions of guilt or TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 5/20 grandiose delusions of power and wealth. Psychotic features, by definition, are absent in hypomanic episodes. Describe mixed features. - Correct Answer️️ -To better account for "mixed features," the current diagnostic criteria implements specifiers. Manic or hypomanic episodes with mixed features meet the full criteria for mania or hypomania and have at least 3 of the following signs or symptoms: depressed mood, anhedonia, psychomotor retardation, fatigue, excessive guilt, or recurrent thoughts of death. Major depressive episodes with mixed features meet the full criteria for a major depressive episode and have at least 3 of the following signs or symptoms: expansive mood, grandiosity, increased talkativeness, flight of ideas, increased goal-directed activity, indulgence in activities with a high potential for "painful consequences," and decreased need for sleep. The mixed features must be present during "most days." Define a manic episode and the 7 criteria points. - Correct Answer️️ -A manic episode is defined as a distinct period of persistently elevated or irri