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Bipolar Case Study

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Will Boney
Wingate PA program
DEC 12, 2014
OVERVIEW FOR BIPOLAR DISORDER, AND TREATMENT QUALITY INDICATORS
QI: Use of group and family based education and therapy as part of psychosocial education in maintenance therapy for Bipolar patients.
I. DEFINITION OF THE DISEASE
A. Bipolar Disorder- Episodes of major depression, hypomania, and/or mania.
Bipolar disorder is the name given to a spectrum of psychological maladies characterized by cyclical episodes of mood disorder in the form of mania and depression, interspersed with periods of relative normalcy. Manic and hypomanic episodes are the hallmark symptoms bipolar disorders, and accurate differentiation between the two is necessary to properly diagnose bipolar types I and II, and to exclude …show more content…

The major criteria are consistently elevated or irritated mood for the majority of 4 days, and, as in manic episodes, the individuals may experience a wide range of symptoms related to increased energy, self-confidence, impulsivity, and risk-taking. Besides a slightly shorter duration of symptoms, the main differentiating factor between hypomania and mania is the degree of impairment. In both states, the level of functioning must be uncharacteristic, and evident to others, but social and work functioning is not markedly impaired in a hypomanic episode. The presence of psychotic symptoms automatically excludes the definition of hypomania, as does an attributable medication or …show more content…

History taking should focus on the presence of mood disturbing episodes, which were described previously. Careful attention must be paid to the duration of symptoms and degree of impairment in order to distinguish between mania and hypomania. The diagnosis of hypomanic episodes in particular is a challenge, since it by definition does not cause impairment, and may be difficult to differentiate from euthymia in a depressed patient. Although the diagnosis of bipolar disorder requires the presence of manic or hypomanic episodes, the majority of patients present with symptoms of depressed, not elevated mood. Thus, the possibility of bipolar disorders must be considered with all patients presenting with depressive episodes. In addition to symptoms, determining family history of psychiatric diagnoses is important, especially in first-degree relatives. Substance abuse is a common comorbidity with bipolar disorder, and patients with bipolar disorder have higher rates of substance abuse than the general population. (Conceptualizing impulsivity and risk taking in bipolar disorder: importance of history of alcohol abuse) Additionally, substance abuse may be a clue to the impulsive, risk taking behavior that is a manifestation of the manic episodes. It is important to note that manic or hypomanic episodes may not be the direct result of medications or substance abuse. Sexual history may

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