Bipolar Disorders - DINU IRANDI.pptx psychiatry

Bipolar disorders

1. Dinu Irandi Jayasinghe Group 09a Bipolar Disorders

2. Bipolar Disorders This disorder is characterized by repeated (at least two) episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (mania or hypomania), and on others of a lowering of mood and decreased energy and activity (depression).

3. Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressions tend to last longer (median length about 6 months) Characteristically, recovery is usually complete between episodes, and the incidence in the two sexes is more nearly equal than in other mood disorders. As patients who suffer only from repeated episodes of mania are comparatively rare, and resemble (in their family history, premorbid personality, age of onset, and long-term prognosis) those who also have at least occasional episodes of depression, such patients are classified as bipolar.

4. ICD Classification F31.0 Bipolar affective disorder, current episode hypomanic (a)the current episode must fulfil the criteria for hypomania (F30.0); and (b)there must have been at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past 6A60.0 Bipolar type I disorder, current episode manic, without psychotic symptoms current episode manic, without psychotic symptoms diagnosed when the definitional requirements for Bipolar type I disorder are met, current episode is manic, and are no delusions or hallucinations present during episode F31.1 Bipolar affective disorder, current episode manic without psychotic symptoms (a)the current episode must fulfil criteria for mania without psychotic symptoms (b)there have at least one other affective episode (hypomanic, manic, depressive, or mixed) past. 6A60.1 Bipolar type I disorder, current episode manic, with psychotic symptoms A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased or a experience of increased energy, F31.2 Bipolar affective disorder, current episode manic with psychotic symptoms (a)the current episode must fulfil the criteria for mania with psychotic symptoms (F30.2); and (b)there must have been at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past. 6A60.2 Bipolar type I disorder, current episode hypomanic current episode hypomanic is diagnosed when the definitional requirements for disorder have met and current episode is hypomanic. A hypomanic episode is a persistent mood state lasting at least several days mild elevation of mood

5. F31.3 Bipolar affective disorder, current episode mild or moderate depression (a)the current episode must fulfil the criteria for a depressive episode of either mild (F32.0) or moderate (F32.1) severity; and (b)there must have been at least one hypomanic, manic, or mixed affective episode in the past. 6A60.3 Bipolar type I disorder, current episode depressive, mild current episode depressive, mild is diagnosed when the definitional requirements for Bipolar type I disorder have been met and the current episode is depressive at a mild level of severity F31.4 Bipolar affective disorder, current episode severe depression without psychotic symptoms ( a)the current episode must fulfil the criteria for a severe depressive episode without psychotic symptoms (b)there must have been at least one hypomanic, manic, or mixed affective episode in the past. 6A60.4 Bipolar type I disorder, current episode depressive, moderate without psychotic symptoms moderate, without psychotic symptoms is diagnosed when the definitional requirements for have met and the current episode is depressive at a moderate level of severity and are no delusions or hallucinations during episode F31.5 Bipolar affective disorder, current episode severe depression with psychotic symptoms (a)the current episode must fulfil the criteria for a severe depressive episode with psychotic symptoms (F32.3); and (b)there must have been at least one hypomanic, manic, or mixed affective episode in the past. 6A60.5 Bipolar type I disorder, current episode depressive, moderate with psychotic symptoms moderate, with psychotic symptoms diagnosed when the definitional requirements for Bipolar type I have been met and current episode is depressive at a mod level of severity and are delusions or hallucinations during episode

6. F31.6 Bipolar affective disorder, current episode mixed The patient has had at least one manic, hypomanic, or mixed affective episode in the past and currently exhibits either a mixture or a rapid alternation of manic, hypomanic, and depressive symptoms. 6A60.6 Bipolar type I disorder, current episode depressive, severe without psychotic symptoms is diagnosed when the definitional requirements for Bipolar type I disorder are met and the current episode is severe and there are no delusions or hallucinations during the episode. F31.7 Bipolar affective disorder, currently in remission The patient has had at least one manic, hypomanic, or mixed affective episode in the past and in addition at least one other affective episode of hypomanic, manic, depressive, or mixed type, but is not currently suffering from any significant mood disturbance, and has not done so for several months. The patient may, however, be receiving treatment to reduce the risk of future episodes. 6A60.7 Bipolar type I disorder, current episode depressive, severe with psychotic symptoms when the definitional requirements for Bipolar type I disorder are met and the current episode is severe and there are delusions or hallucinations during the episodes lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness F31.8 Other bipolar affective disorders F31.9 Bipolar affective disorder, unspecified A60.8 Bipolar type I disorder, current episode depressive, unspecified severity A60.9 Bipolar type I disorder, current episode mixed, without psychotic symptoms

7. ICD 11 cont.. 6A60.A Bipolar type I disorder, current episode mixed, with psychotic symptoms 6A60.B Bipolar type I disorder, currently in partial remission, most recent episode manic or hypomanic 6A60.C Bipolar type I disorder, currently in partial remission, most recent episode depressive 6A60.D Bipolar type I disorder, currently in partial remission, most recent episode mixed 6A60.E Bipolar type I disorder, currently in partial remission, most recent episode unspecified 6A60.F Bipolar type I disorder, currently in full remission 6A60.Y Other specified bipolar type I disorder 6A60.Z Bipolar type I disorder, unspecified

8. ICD 11 cont … Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality . There is no history of manic or mixed Episodes

9. 6A61.0 Bipolar type II disorder, current episode hypomanic 6A61.1 Bipolar type II disorder, current episode depressive, mild 6A61.2 Bipolar type II disorder, current episode depressive, moderate without psychotic symptoms 6A61.3 Bipolar type II disorder, current episode depressive, moderate with psychotic symptoms 6A61.4 Bipolar type II disorder, current episode depressive, severe without psychotic symptoms 6A61.5 Bipolar type II disorder, current episode depressive, severe with psychotic symptoms 6A61.6 Bipolar type II disorder, current episode depressive, unspecified severity 6A61.7 Bipolar type II disorder, currently in partial remission, most recent episode hypomanic 6A61.8 Bipolar type II disorder, currently in partial remission, most recent episode depressive 6A61.9 Bipolar type II disorder, currently in partial remission, most recent episode unspecified