Chapter 39. Bipolar Disorder
Factors that increase risk of suicide in individuals with bipolar disorder include which of the following?
A. A high number of depressive episodes
C. Low educational status
D. Negative family history of bipolar disorder
Option A: Correct. Patients with bipolar disorder have high risk of suicide. Factors that increase risk are early age at onset, high number and severity of depressive episodes, comorbid alcohol use disorder, comorbid personality disorder, history of antidepressant-induced mania, history of previous suicide attempt, and family history of suicidal behavior.
Option B: Incorrect. Early age of onset is a risk factor, not late age.
Option C: Incorrect. Educational status does not change risk of suicide.
Option D: Incorrect. Family history of suicidal behavior is a risk factor for suicide in bipolar disorder. Negative family history of bipolar disorder doesn't change the suicide risk.
Epidemiologic studies show patients with bipolar I disorder spend:
A. More time manic than depressed
B. More time depressed than manic
C. The same amount of time manic and depressed
D. More time acutely ill than stable
Option A: Incorrect. Patients spend more time depressed than manic.
Option B: Correct. Studies show patients with bipolar I spend about 32% of weeks with depressive symptoms compared with 9% of weeks with manic or hypomanic symptoms. Patients with bipolar II disorder spend 50% of weeks symptomatic for depression and only 1% with hypomania.
Option C: Incorrect. Patients spend more time depressed than manic.
Option D: Incorrect. Studies show patients spend ~41% of weeks with depressive, manic, or hypomanic symptoms, which is not a majority of the time.
Which of the following is another psychiatric illness that can include a history of manic episodes?
A. Major depressive disorder
C. Schizoaffective disorder
Option A: Incorrect. Major depressive disorder is not associated with mania. If someone has a history of MDD and has a "true" manic episode, the diagnosis changes to bipolar I disorder.