Bipolar%20disorder Signs and Symptoms

Signs and Symptoms

Introduction

Mood disorder characterized by episodic, recurrent and frequently progressive condition of mania, hypomania and major depression
Age of onset is between 15 and 30 years old with overall average of 25 years old
An estimated 2.4% total lifetime prevalence reported by the World Mental Health Survey across bipolar I, bipolar II and subthreshold bipolar disorder subtypes
Associated with increased comorbidity with substance abuse, anxiety disorder, personality disorders and attention-deficit hyperactivity disorder (ADHD)
- Comorbidity with axis I or axis II may be associated with an earlier age at onset and a worse course of illness

Bipolar Subtypes

Bipolar I

Primarily defined by manic or mixed episodes that last for at least 7 days, or very severe manic symptoms needing immediate hospital care
Patient also has depressive episodes that may last for at least 2 weeks

Bipolar II

Usually misdiagnosed; characterized by occurrence of ≥1 major depressive episodes with at least 1 hypomanic episode

Other Specified Bipolar and Related Disorder or Unspecified Bipolar and Related Disorder

Patient has symptoms that do not meet the criteria for either bipolar I or II
- Symptoms may not last long or are very few

Bipolar Spectrum Disorders

Cyclothymic Disorder or Cyclothymia

A mild form of bipolar disorder
Patients have episodes of hypomania alternating with mild depression that lasts for 2 years

Rapid-Cycling Bipolar Disorder

Patients have ≥ 4 episodes of major depression, mania, hypomania or mixed symptoms within a year
More common in patients with severe bipolar disorder, in people who had the disease at an earlier age and in female patients

Signs and Symptoms

Clinical Course

Patient may present with bipolar disorder in a manic, hypomanic, depressive or mixed state
More common for 1st episode to present as depression
Often, the patient will suffer from a number of depressive episodes before a manic episode occurs
Features of bipolar disorder vary and can be traced by recording using daily mood chart
Patients with bipolar disorder have the highest risk for suicide
- Knowing risk factors (eg younger age, male, unemployed, early onset of mood disorder, 1st-degree family history of suicide) can help in detection of patients who are at risk for suicide

Depression

Depressive symptoms occur more commonly than manic symptoms throughout the course of illness
- Bipolar I patients have depression 3 times more frequent than mania
- Bipolar II patients experience depression 37 times more commonly than hypomania

Episodes of depression are similar to unipolar major depression
- Bipolar depression occurs more commonly in patients with family history of bipolar disorder and in patients with early onset of depression

Subsyndromal episodes associated with loss of interpersonal skills and occupational ability are common in patients with bipolar disorder

Mania

Extreme behaviors associated with manic episodes often require hospital admission to prevent harm to self and others
Acute phase of mania may involve extreme affect, often euphoric or irritable
Causes impairment in perception, somatic and social functioning

Hypomania

Also have features of mania but at a lesser extent, where insight is preserved
Usually accompanied by mild functional impairment
Can be assessed using the Hypomania Symptom Checklist (HCL-32), Mood Disorders Questionnaire (MDQ),Young Mania Rating Scale (YMRS)

Long COVID: What we have learned so far

Prof. Ghassan Dbaibo, 27 Apr 2023

The WHO defines long COVID as a condition that occurs 3 months from COVID-19 onset, whose symptoms last ≥2 months and cannot be attributed to an alternative diagnosis. In an interview with MIMS Doctor, Professor Ghassan Dbaibo of the Center for Infectious Diseases, American University of Beirut, Beirut, Lebanon, describes the evolving attitudes towards long COVID among healthcare professionals (HCPs), some unexpected predisposing factors, potential biological mechanisms behind prolonged symptom duration and shares data on vaccination’s protective effects against long COVID.

NCDs in Focus Act Now! Summit 2022

16 Mar 2023

Viatris, a global healthcare company, collaborated with the Thai Hypertension Society and the Thai NCD Collaboration Group to organize the NCDs in Focus Act Now! Summit 2022 in Bangkok on October 29^th and 30^th. This summit brought together nearly 300 multidisciplinary experts from Southeast Asia and India to address the unmet needs in managing two critical noncommunicable diseases (NCDs): cardiovascular diseases (CVDs) and mental health disorders (MHDs) in the region.

The summit had several key objectives. Firstly, it highlighted the effectiveness of clinical data in addressing gaps and unmet needs in clinical practice. Secondly, it emphasized the importance of sharing expertise and best practices through a platform that can optimize patient care. Additionally, it discussed the challenges of cardiovascular disease and mental health disorder care in a post COVID-19 world, and the need to re-examine them.

The summit also offered valuable insights into policy and practice changes, as well as innovative digital solutions that can lead to better outcomes. Lastly, it emphasized the significance of gaining a deeper understanding of the gaps in the patient journey to enhance patient care further.

Overall, the NCDs in Focus Act Now! Summit 2022 was a highly informative and productive event, with experts collaborating to improve the management of CVDs and MHDs in Southeast Asia and India.