Deck 4: Bipolar and Related Disorders

Question 1

Which of the following statements best apply to a person with "rapid cycling":

A)Has a more positive prognosis
B)Experiences at least four manic or depressive episodes within a year
C)Experiences manic symptoms only during certain times of the year
D)Has a less severe form of Bipolar disorder

Answer 1

B

Question 2

Which of the following features indicates a worse prognosis for someone with bipolar I disorder?

A)Younger age at onset
B)Marital status
C)Less severe depressive episodes
D)Rapid cycling

Answer 2

D

Question 3

What is the difference between the depressive episodes associated with bipolar II disorder from those associated with bipolar I disorder?

A)They are less frequent than those associated with bipolar I disorder
B)They are lengthier than those associated with bipolar I disorder
C)They are less severe that those episodes associated with bipolar I disorder
D)They are less disabling that those associated with bipolar I disorder

Answer 3

B

Question 4

A client with a history of bipolar disorder tells the social worker that he has experienced 1 week of an elevated and expansive mood. Which of the following would suggest that this client is having a hypomanic rather than a manic episode?

A)Irritability
B)Increased productivity at work
C)Feels rested after only 3 hours of sleep
D)Good insight into his condition

Question 5

Psychotic features are very rarely noted in the Bipolar I disorder.

Question 6

Euphoria, boundless optimism, inflated self-esteem and grandiosity are characteristic symptoms of Bipolar I disorder, current or most recent episode manic.

Question 7

Kevin Sanders is a 34 year old man who has been feeling unusually irritable for the past week. He tells the social worker that during this period of time he has had increased energy and activity and sleeps less. Kevin admits that it has been difficult for him to complete reports on the job. His supervisor has become concerned and referred Kevin to the Employee Assistance Department. "I have rapid, pressured speech, and I can't seem to stop talking." said Kevin. He adds, "I just can't seem to sit still, either." The social worker notices that Kevin was easily distracted. Kevin is in good health and takes no medications. What diagnosis best fits Kevin's symptom picture?

A)Bipolar I disorder, with mixed features
B)Hypomanic episode
C)Manic episode
D)Cyclothymic disorder

Question 8

The change in the criteria for bipolar and related disorders from the DSM-IV-TR to the DSM-5 is best represented by:

A)The clinical symptoms for hypomanic episodes have been substantially changed
B)Criteria for the bipolar disorders now include changes in mood and changes in activity or energy
C)Hypomania has now been removed from the conditions allowed under the diagnosis of other specified bipolar and related disorder
D)Bipolar I disorder specified with mixed features now requires the person to meet full criteria for both manic or hypomanic), and depressive episodes

Question 9

Those with a diagnosis of Bipolar II disorder will likely require hospitalization at some point during the course of the illness.

Question 10

Manic symptoms that can be attributed to the physiological effects of a drug of abuse, the side effects of medications or treatments, or another medical condition do not count toward the diagnosis of bipolar I disorder.

Question 11

Gene Colman has a history of bipolar I disorder. He currently presents with a new-onset manic episode and it has been successfully treated with an adjustment in his medication. He tells the social worker that he has had chronic depressive symptoms that, looking back, preceded his manic episodes. These symptoms of depression were described as "feeling down," decreased energy, and more often than not having no motivation. While Gene denies other depressive symptoms, he contacted the social worker because his wife has started to complain about his "unpredictable" behavior. "My wife never complained when I was depressed because she knew what to expect," said Gene. What is the most likely diagnosis for Gene?

A)Bipolar I disorder and persistent depressive disorder dysthymia)
B)Bipolar II disorder, current episode hypomanic
C)Other specified bipolar and related disorder
D)Cyclothymic disorder

Question 12

Bipolar I disorder is characterized by severe alterations in mood that are usually episodic and recurrent.

Question 13

A family practice physician who has an office in the same building where you have your private practice refers one of his patients to you suspecting medication abuse. You see a 48 year old man, John Clay Edsel, who tells you that his doctor prescribed an antidepressant to help him with his symptoms of a major depressive episode. In a rapid-fire fashion, Mr. Edsel very quickly describes his symptom picture. As soon as he started his antidepressant medication, Mr. Edsel reported that he began to have increased energy, racing thoughts, found it hard to sit still, and it was difficult for him to concentrate. Mr. Edsel also related a decreased need for sleep adding, "Three hours is all I need to wake up refreshed. I'll sleep longer when I'm retired." He adds, "After about 2 or 3 days I quit taking the antidepressants." Mr. Edsel's depression stopped but the new symptoms have continued. What is Mr. Edsel's diagnosis?

A)Major depressive disorder
B)Cyclothymic disorder
C)Bipolar II disorder
D)Bipolar I disorder

Question 14

Imagine for a moment that you have an adolescent on your caseload who presents with distractibility. Which of the following symptoms would suggest more of an association with the bipolar II symptom picture rather than attention-deficit/hyperactivity disorder?

A)Rapid speech
B)Complaints of racing thoughts
C)Evidence that symptoms are episodic
D)Reports a less need for sleep

Question 15

Mason Turner has had "mood swings" for about the past five years. His "high" periods are relatively short-lived and are characterized by an increase in goal-directed activity and an inflated sense of self-esteem. When Mason experiences "low" periods, they, too, are of short duration and characterized by a depressed mood and subsequent fatigue. While Mason does not consider his present problems severe, his wife, Yvonne, feels that he might need some help. Given these symptoms, Mason is most likely suffering from which mood disorder?

A)Double depression
B)Persistent depressive disorder dysthymia)
C)Bipolar I disorder
D)Cyclothymic disorder

Question 16

The diagnostic features of substance/medication-induced bipolar and related disorder are essentially the same as those for mania, hypomania, or depression.

Question 17

Which of the following symptoms differentiates cyclothymic disorder from bipolar I disorder?

A)Severity
B)Hypomanic episodes
C)Major depressive episodes
D)All of the above

Question 18

Of the bipolar disorders, bipolar I is less serious than bipolar II.

Question 19

The essential feature of cyclothymic disorder is a chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and periods of depressive symptoms that are distinct from each other.

Question 20

Mason Turner has had "mood swings" for about the past five years. His "high" periods are relatively short-lived and are characterized by an increase in goal-directed activity and an inflated sense of self-esteem. When Mason experiences "low" periods, they, too, are of short duration and characterized by a depressed mood and subsequent fatigue. While Mason does not consider his present problems severe, his wife Evette, feels that he might need some help. Given these symptoms, Mason is most likely suffering from which mood disorder?

A)Double depression
B)Bipolar II disorder
C)Bipolar I disorder
D)Cyclothymic disorder

Question 22

Attention-deficit/hyperactivity disorder ADHD) may be misdiagnosed as bipolar II disorder, especially in adolescents and children.