NURS 663 Exam Questions and Answers (Graded A)
Bipolar I Disorder Criteria
At least one lifetime manic episode is required for this diagnosis. A distinct period of
abnormally and persistently elevated, expensive, or irritable mood and abnormally and
persistently increased goal directed activity or energy, lasting at least one week and
present most of the days nearly every day or any duration if hospitalization is
necessary.
The episode is not attributable to the physiological effects of a substance example a
drug of abused a medication, other treatment or to another medical condition. Note; for
manic episode that emerges during antidepressant treatment example medication,
electroconvulsive therapy, but persist at a fully syndromal level beyond the physiological
effect of the treatment is sufficient evidence for manic episode And therefore this
diagnosis.
Bipolar II Diagnostic Criteria
Criteria have been met for at least one hypomanic episode AND at least one major
depressive episode
there has never been a manic episode
-not better explained by...
-the symptoms of depression or the unpredictability caused by frequent alternation
between periods of depression and hypomania causes clinically significant distress or
impairment in social, occupational or other important areas of functioning
Specifiers:
-with anxious distress
-with mixed features
-with rapid cycling (at least 4 mood episodes in past 12 months)
-with melancholic features
-with atypical features
-with mood-congruent psychotic features
-with mood-incongruent psychotic features
-with catatonia
-with peripartum onset
-with seasonal pattern
Note difference between cyclothymia and bipolar II
-bipolar II has ONE OR MORE MAJOR DEPRESSIVE EPISODES
-if major depressive episode occurs after the first 2 years of cyclothymic disorder, the
additional diagnosis of bipolar II is given
cyclothymic disorder
This diagnosis is given to adults who experience at least two years or for children one
year of both hypo manic and depressive periods without fulfilling the criteria for an
episode of mania, hypo mania, or major depression.
Bipolar I disorder
, must meet criteria for a manic episode. A distinct period of abnormally and persistently
elevated, expansive, or irritable mood and abnormally and persistently increased goal
directed activity or energy lasting at least one week. During the mood disturbance three
other symptoms must be present, or four if the mood is only irritable.
Bipolar I disorder symptoms
Manic symptoms along with:
Increased self-esteem or grandiosity
Decrease need for sleep; feels rested after only three hours.
More talkative than usual or pressure to keep talking
Flights of ideas or subjective experience that thoughts are racing.
Distractibility; attention too easily drawn to unimportant or irrelevant external stimuli as
reported or observed.
Increased in goal directed activity; either socially, at work or school or sexually or
psycho motor agitation; purposeless non-goal directed activity.
Excessive involvement in activities that have a high potential for painful consequences
such as, engaging in unrestrained buying spree's, sexual indiscretion or foolish
business investments.
Marked mood disturbance with impairment in social or occupational functioning.
Hospitalization due to their threat to hurt self or others, or other psychotic features.
The symptoms are not attributed to physiological effects of a substance, or other
medical condition.
Bipolar II Disorder
For diagnosis of this disorder it is necessary to meet the following criteria for a current
or past hypo manic episode and the following criteria for occurring or past depressive
episode.
Hypo manic episode criteria
A. A distinct. Of abnormally or persistently elevated, expansive, or irritable mood and
abnormally and persistently increased activity or energy, lasting at least four
consecutive days and present most of the day, nearly every day.
Be. During the period of mood disturbance and increase energy and activity, three or
more of the following symptoms have persisted for if the mood is only irritable.
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep; feels rested after only three hours of sleep
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility; attention too easily drawn to unimportant or irrelevant external stimuli,
as reported or observed.
6. Increase in goal directed activity; either socially, at work or school, or sexually, or
psycho motor agitation.
7. Excessive involvement in activities that have a high potential for painful
consequences example; in unrestrained fines freeze, sexual indiscretions, or foolish
business investments.
* The episode is not severe enough to cause marked impairment in social or
occupational functioning or to necessitate hospitalization. If there are psychotic features
the episode is by definition manic.
Bipolar I Disorder Criteria
At least one lifetime manic episode is required for this diagnosis. A distinct period of
abnormally and persistently elevated, expensive, or irritable mood and abnormally and
persistently increased goal directed activity or energy, lasting at least one week and
present most of the days nearly every day or any duration if hospitalization is
necessary.
The episode is not attributable to the physiological effects of a substance example a
drug of abused a medication, other treatment or to another medical condition. Note; for
manic episode that emerges during antidepressant treatment example medication,
electroconvulsive therapy, but persist at a fully syndromal level beyond the physiological
effect of the treatment is sufficient evidence for manic episode And therefore this
diagnosis.
Bipolar II Diagnostic Criteria
Criteria have been met for at least one hypomanic episode AND at least one major
depressive episode
there has never been a manic episode
-not better explained by...
-the symptoms of depression or the unpredictability caused by frequent alternation
between periods of depression and hypomania causes clinically significant distress or
impairment in social, occupational or other important areas of functioning
Specifiers:
-with anxious distress
-with mixed features
-with rapid cycling (at least 4 mood episodes in past 12 months)
-with melancholic features
-with atypical features
-with mood-congruent psychotic features
-with mood-incongruent psychotic features
-with catatonia
-with peripartum onset
-with seasonal pattern
Note difference between cyclothymia and bipolar II
-bipolar II has ONE OR MORE MAJOR DEPRESSIVE EPISODES
-if major depressive episode occurs after the first 2 years of cyclothymic disorder, the
additional diagnosis of bipolar II is given
cyclothymic disorder
This diagnosis is given to adults who experience at least two years or for children one
year of both hypo manic and depressive periods without fulfilling the criteria for an
episode of mania, hypo mania, or major depression.
Bipolar I disorder
, must meet criteria for a manic episode. A distinct period of abnormally and persistently
elevated, expansive, or irritable mood and abnormally and persistently increased goal
directed activity or energy lasting at least one week. During the mood disturbance three
other symptoms must be present, or four if the mood is only irritable.
Bipolar I disorder symptoms
Manic symptoms along with:
Increased self-esteem or grandiosity
Decrease need for sleep; feels rested after only three hours.
More talkative than usual or pressure to keep talking
Flights of ideas or subjective experience that thoughts are racing.
Distractibility; attention too easily drawn to unimportant or irrelevant external stimuli as
reported or observed.
Increased in goal directed activity; either socially, at work or school or sexually or
psycho motor agitation; purposeless non-goal directed activity.
Excessive involvement in activities that have a high potential for painful consequences
such as, engaging in unrestrained buying spree's, sexual indiscretion or foolish
business investments.
Marked mood disturbance with impairment in social or occupational functioning.
Hospitalization due to their threat to hurt self or others, or other psychotic features.
The symptoms are not attributed to physiological effects of a substance, or other
medical condition.
Bipolar II Disorder
For diagnosis of this disorder it is necessary to meet the following criteria for a current
or past hypo manic episode and the following criteria for occurring or past depressive
episode.
Hypo manic episode criteria
A. A distinct. Of abnormally or persistently elevated, expansive, or irritable mood and
abnormally and persistently increased activity or energy, lasting at least four
consecutive days and present most of the day, nearly every day.
Be. During the period of mood disturbance and increase energy and activity, three or
more of the following symptoms have persisted for if the mood is only irritable.
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep; feels rested after only three hours of sleep
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility; attention too easily drawn to unimportant or irrelevant external stimuli,
as reported or observed.
6. Increase in goal directed activity; either socially, at work or school, or sexually, or
psycho motor agitation.
7. Excessive involvement in activities that have a high potential for painful
consequences example; in unrestrained fines freeze, sexual indiscretions, or foolish
business investments.
* The episode is not severe enough to cause marked impairment in social or
occupational functioning or to necessitate hospitalization. If there are psychotic features
the episode is by definition manic.
