Bipolar Disorder Questions & Answers

Updated: May 30, 2019
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
  • Print
Questions & Answers

Overview

What is bipolar affective disorder (manic-depressive illness)?

How is mania in bipolar affective disorder (manic-depressive illness) characterized?

How is hypomania diagnosed in bipolar affective disorder (manic-depressive illness)?

How are major depressive episodes diagnosed in bipolar affective disorder (manic-depressive illness)?

What is included in the Mental Status Exam for bipolar affective disorder (manic-depressive illness)?

Which lab tests are performed in the evaluation of bipolar affective disorder (manic-depressive illness)?

What is the role of electrocardiography in the evaluation of bipolar affective disorder (manic-depressive illness)?

What is the focus of treatment for bipolar affective disorder (manic-depressive illness)?

Which medications are used in the treatment of bipolar affective disorder (manic-depressive illness?)

What are the nondrug treatment options for bipolar affective disorder (manic-depressive illness)?

What is bipolar affective disorder (manic-depressive illness)?

How is bipolar affective disorder (manic-depressive illness) characterized?

What are the symptoms of mania in bipolar affective disorder (manic-depressive illness)?

How are unipolar (major depressive) disorder and bipolar affective disorder (manic-depressive illness) differentiated?

How is bipolar affective disorder defined in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5)?

What is the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What is the role of genetics in the pathogenesis of bipolar affective disorder (manic-depressive illness)?

What is the role of the major affective disorder (MAFD) loci in the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What is the role of the ANK3 (ankyrin G) and CACNA1C (alpha 1C subunit of the L-type voltage-gated calcium channel) genes in the pathogenesis of bipolar affective disorder (manic-depressive illness)?

Why is the CACNA1C gene associated with bipolar affective disorder (manic-depressive illness)?

What is the evidence of common susceptibility genes for bipolar affective disorder (manic-depressive illness) and schizophrenia?

What is the evidence of single-nucleotide polymorphisms (SNPs) as etiologic factors in bipolar affective disorder (manic-depressive illness)?

How are differences in bipolar affective disorder (manic-depressive illness) phenotypes explained?

What is association of the DGKH gene and lithium regulation in bipolar affective disorder (manic-depressive illness)?

What is the role of glycogen synthase kinase 3-beta (GSK3?) in the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What are endophenotypes in bipolar affective disorder (manic-depressive illness)?

What is the role of the NCAN gene in the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What is the role of estrogen receptor binding site variation in the pathophysiology of bipolar affective disorder (manic-depressive illness) in females?

What is the association between large copy number genetic variants and bipolar affective disorder (manic-depressive illness)?

How does deletions throughout the genome increase the risk for bipolar affective disorder (manic-depressive illness)?

What have gene expression studies increase understanding of the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What findings on gene expression and neuroimaging studies suggest bipolar affective disorder (manic-depressive illness) and schizophrenia share a biologic etiology?

What findings of gene expression in rat brains have increased understanding of the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What is the role of hippocampal neurons in the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What is the role of neuroplasticity and cellular resiliency in the pathophysiology of bipolar affective disorder (manic-depressive illness)?

What is the role of electrophysiologic kindling and behavioral sensitization processes in the pathophysiology of bipolar affective disorder (manic-depressive illness)?

Which factors contribute to the etiology of bipolar affective disorder (manic-depressive illness)?

What is the genetic component to the etiology of bipolar affective disorder (manic-depressive illness)?

What are the risk factors for the development of bipolar disorder type I (BPI)?

What has been learned from twin studies about the etiology of bipolar disorder type I (BPI)?

What has been learned from adoption studies about the etiology of bipolar disorder type I (BPI)?

What is etiologic relationship between schizophrenia spectrum disorders and bipolar affective disorder (manic-depressive illness)?

What findings from gene expression studies support a shared etiologic factors for bipolar affective disorder (manic-depressive illness), major depression, and schizophrenia?

What is the role of biochemical pathways in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the catecholamine hypothesis of the etiology of bipolar affective disorder (manic-depressive illness?)

Which drugs are implicated in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the etiologic relationship between substance-induced psychosis and bipolar affective disorder (manic-depressive illness [manic-depressive illness])?

What is the role of glutamate in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the role of calcium regulation in the etiology of bipolar affective disorder (manic-depressive illness)?

Which biochemical factors may contribute to the etiology of bipolar affective disorder (manic-depressive illness)?

What is the role of neurophysiologic factors in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the role of white matter hypersensitivities (WMH) in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the role of psychodynamic factors in the etiology of bipolar affective disorder (manic-depressive illness)?

Which personality disturbances are associated with bipolar affective disorder (manic-depressive illness)?

What is the role of environmental factors in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the role of pharmacological factors in the etiology of bipolar affective disorder (manic-depressive illness)?

What is the prevalence of bipolar affective disorder (manic-depressive illness) in the US?

What is the global prevalence of bipolar affective disorder (manic-depressive illness)?

In what age groups is the onset of bipolar affective disorder (manic-depressive illness) most likely?

How does the incidence of bipolar affective disorder (manic-depressive illness) vary by sex?

What are the morbidity and mortality rates for bipolar affective disorder (manic-depressive illness)?

Which factors are associated with a worse prognosis for bipolar affective disorder (manic-depressive illness)?

Which factors are associated with a better prognosis for bipolar affective disorder (manic-depressive illness)?

What is the role of patient education in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the focus of patient education in bipolar affective disorder (manic-depressive illness)?

Why is patient education on the biology of bipolar affective disorder (manic-depressive illness) important?

Why is patient education on the stressors in bipolar affective disorder (manic-depressive illness) important?

How is sharing individual stories of patients with bipolar affective disorder (manic-depressive illness) important?

What are the important sources of information for patients and families about bipolar affective disorder (manic-depressive illness)?

Presentation

What is improved with a correct diagnosis of bipolar affective disorder (manic-depressive illness)?

What should be the focus of history in suspected bipolar affective disorder (manic-depressive illness)?

What is required for the diagnosis of bipolar disorder type I (BPI)?

Which symptoms must be present for the diagnosis of manic episodes in bipolar affective disorder (manic-depressive illness)?

Which symptoms must be present for the diagnosis of hypomanic episodes in bipolar affective disorder (manic-depressive illness)?

Which symptoms must be present for the diagnosis of major depressive episodes in cases of bipolar affective disorder (manic-depressive illness)?

When is the DSM-5 mixed features specifier used in the diagnosis of bipolar disorder?

How is bipolar affective disorder (manic-depressive illness) characterized?

Which symptoms must be present for the diagnosis of manic episodes in bipolar affective disorder (manic-depressive illness)?

Which symptoms must be present for the diagnosis of hypomanic episodes in bipolar affective disorder (manic-depressive illness)?

Which symptoms must be present for the diagnosis of major depressive episodes in cases of bipolar affective disorder (manic-depressive illness)?

DDX

How is bipolar affective disorder (manic-depressive illness) diagnosed?

Which conditions should be included in the differential diagnoses of bipolar affective disorder (manic-depressive illness)?

What are the differential diagnoses for Bipolar Disorder?

Workup

What is the role of lab studies in the evaluation of bipolar affective disorder (manic-depressive illness)?

Why should encephalitis be included in the differential diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of complete blood count (CBC) in the diagnosis of bipolar affective disorder (manic-depressive illness)?

How does lithium affect lab test findings in the evaluation of bipolar affective disorder (manic-depressive illness)?

What is the role of erythrocyte sedimentation rate in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of fasting glucose in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of electrolyte measurement in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of serum calcium assessment in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the significance of low protein levels in bipolar affective disorder (manic-depressive illness)?

What is the role of biomarkers in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of thyroid tests in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of creatinine and blood urea nitrogen (BUN) levels in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of the liver and lipid panel in the diagnosis of bipolar affective disorder (manic-depressive illness)?

Which lab tests may be indicated in the diagnosis of bipolar affective disorder (manic-depressive illness)?

Why should alcohol and substance abuse be included in the differential diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of a substance screen in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of MRI in the diagnosis of bipolar affective disorder (manic-depressive illness)?

What is the role of ECG in the management of bipolar affective disorder (manic-depressive illness)?

When is EEG indicated for bipolar affective disorder (manic-depressive illness)?

Treatment

What factors affect treatment response in bipolar affective disorder (manic-depressive illness)?

How is the response to treatment in bipolar affective disorder (manic-depressive illness) evaluated?

Which dangerous conditions should be evaluated for in patients with bipolar affective disorder (manic-depressive illness)?

How is treatment for bipolar affective disorder (manic-depressive illness) directed?

How should medications be evaluated prior to treatment for bipolar affective disorder (manic-depressive illness)?

What monitoring in needed following initiation of medication for the treatment of bipolar affective disorder (manic-depressive illness)?

What are treatment options for bipolar affective disorder (manic-depressive illness) nonresponsive to medications?

What is the role of outpatient monitoring in bipolar affective disorder (manic-depressive illness)?

What are the Veterans Administration/Department of Defense (VA/DoD) clinical practice treatment guidelines for bipolar affective disorder (manic-depressive illness)?

What is the role of surgery in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the indications for inpatient treatment in bipolar affective disorder (manic-depressive illness)?

When is urgent or emergency mental health intervention indicated in bipolar affective disorder (manic-depressive illness)?

How is the risk of suicide managed in bipolar affective disorder (manic-depressive illness)?

Which factors increase the likelihood of suicide in patients with bipolar affective disorder (manic-depressive illness)?

How might a patient with bipolar affective disorder (manic-depressive illness) be a threat to others?

Which behaviors during a manic episode are indications for hospitalization in bipolar affective disorder (manic-depressive illness)?

What comorbid medical conditions may require monitoring in patients with bipolar affective disorder (manic-depressive illness)?

During which phase of bipolar affective disorder (manic-depressive illness) might a patient be both suicidal and homicidal?

What are indications for hospitalization during a manic phase of bipolar affective disorder (manic-depressive illness)?

When is partial hospitalization or day treatment indicated for bipolar affective disorder (manic-depressive illness)?

What are the major goals of outpatient treatment for bipolar affective disorder (manic-depressive illness)?

What are the benefits of psychotherapy in the treatment of bipolar affective disorder (manic-depressive illness)?

What are somatic health issues associated with bipolar affective disorder (manic-depressive illness)?

What are Collaborative Chronic Care Models (CCMs) for the treatment of bipolar affective disorder (manic-depressive illness)?

Which pharmacologic treatment regimens are used in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the medication treatment options for bipolar affective disorder (manic-depressive illness)?

Why should multiple antidepressant trials be avoided in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of inhaled loxapine in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of combined therapy in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the treatment regimens for nonhospitalized patients with bipolar affective disorder (manic-depressive illness)?

What are the pharmacologic treatments for mania/hypomania or mixed episodes in bipolar affective disorder (manic-depressive illness)?

Which medications are recommended by the American Psychiatric Association's (APA) for the acute treatment of depression in bipolar disorder type I (BPI)?

What are the VA/DoD guidelines for monotherapy in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the VA/DoD guidelines for combination therapies in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the importance of dosing or medication adjustments in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of lithium in the treatment bipolar affective disorder (manic-depressive illness)?

What is the role of atypical antipsychotics in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of ketamine in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the efficacy of antidepressants for the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of mood-stabilizing drugs in the treatment of bipolar affective disorder (manic-depressive illness)?

Which atypical antipsychotics are used in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the pharmacologic treatment options for depression in bipolar disorder type II (BPII)?

What is the role of mood stabilizers and antipsychotic medications in maintaining therapy for bipolar affective disorder (manic-depressive illness)?

What is the Polarity Index and how is it used in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the adverse effects of ziprasidone in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of aripiprazole in the treatment of bipolar affective disorder (manic-depressive illness)?

What are the most efficacious treatments for bipolar affective disorder (manic-depressive illness)?

What is the efficacy of benzodiazepines in the treatment of bipolar affective disorder (manic-depressive illness)?

What guidelines are available for the treatment of children and adolescents with bipolar affective disorder (manic-depressive illness)?

What is the role of risperidone in the treatment of bipolar affective disorder (manic-depressive illness) in children?

What is the risk of lamotrigine in the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of second-generation antipsychotic (SGA) polytherapy for the treatment of bipolar affective disorder (manic-depressive illness)?

What is the role of electroconvulsive therapy (ECT) in the treatment of bipolar affective disorder (manic-depressive illness)?

When is electroconvulsive therapy (ECT) indicated for the treatment of bipolar affective disorder (manic-depressive illness)?

When is electroconvulsive therapy (ECT) recommended by the VA/DoD for primary treatment of bipolar affective disorder (manic-depressive illness)?

What are the dietary restrictions for patients with bipolar affective disorder (manic-depressive illness)?

What are the activity restrictions for patients with bipolar affective disorder (manic-depressive illness)?

What are the main complications of bipolar affective disorder (manic-depressive illness)?

What is the risk of suicide in patients with bipolar affective disorder (manic-depressive illness)?

Which factors may increase the risk for suicidal behaviors in bipolar affective disorder (manic-depressive illness)?

What are behaviors of patients at risk for homicidal behavior in bipolar affective disorder (manic-depressive illness)?

What are the complications associated with addiction in patients with bipolar affective disorder (manic-depressive illness)?

What are the increased risks in patients with dual diagnosis of substance abuse and bipolar affective disorder (manic-depressive illness)?

How does bipolar affective disorder (manic-depressive illness) affect quality of life (QOL)?

How common is progression to bipolar affective disorder (manic-depressive illness) in patients with hypomania?

What is the risk of bipolar affective disorder (manic-depressive illness) in children and adolescents with severe emotional lability?

What is the risk for bipolar affective disorder (manic-depressive illness) in children with severe mood dysregulation?

What is the role of prevention in the management of bipolar affective disorder (manic-depressive illness)?

What is included in long-term monitoring of affective disorder (manic-depressive illness)?

How frequently should patients with bipolar affective disorder (manic-depressive illness) be monitored?

What are the long-term treatment and prophylactic regimens for bipolar affective disorder (manic-depressive illness)?

Medications

How are medications selected for the treatment of bipolar affective disorder (manic-depressive illness)?

Which medications in the drug class Antiparkinson Agents, Dopamine Agonists are used in the treatment of Bipolar Disorder?

Which medications in the drug class Antipsychotics, Phenothiazine are used in the treatment of Bipolar Disorder?

Which medications in the drug class Antipsychotics, 1st Generation are used in the treatment of Bipolar Disorder?

Which medications in the drug class Antipsychotics, 2nd Generation are used in the treatment of Bipolar Disorder?

Which medications in the drug class Anticonvulsants are used in the treatment of Bipolar Disorder?

Which medications in the drug class Mood stabilizers are used in the treatment of Bipolar Disorder?

Which medications in the drug class Anxiolytics, Benzodiazepines are used in the treatment of Bipolar Disorder?