The document provides an overview of various DSM-5 mental disorders relevant for the NCMHCE study, focusing on bipolar disorders, including Bipolar I, Bipolar II, and cyclothymic disorder. It details symptoms, diagnostic criteria, co-occurring conditions, treatment options such as medications and therapy, and monitoring strategies. The document emphasizes the importance of family history and assessment in treatment planning and aims to decrease risks and improve patient outcomes.

1. Review of DSM5 Mental Disorders for NCMHCE Study

2. 1. Bipolar I Disorders
2. Bipolar II Disorder
3. Cyclothymic Disorder
4. Substance/ Medication Induced Biolar and Related
Disorder

3. Diagnosis I
Typically repetitive cycle
of depression and mania,
possibly between
depressive episodes
Either phase can lead to
delusions and
hallucinations
Chronic but can have
years between episodes
Often begins in early 20s
1. Manic periods
 Abnormal high or irritable mood
 Increased energy and goal-
directed activity
 Lasts 1 week or more (less if
hospitalized)
 Includes 3-4 of:
 Grandiosity
 Racing thoughts
 Little sleep
 Distractibility
 High risk activities
 Pressured speech and activity
2. Sufficient intensity of episode

4. Diagnosis II
Specifiers include kinds and how current the episodes:
 Major depression
 Hypomania
 Mania
 Mixed
 Rapid cycling (four mood episodes without break during
the last 12 month period)
Mood is most of the time, nearly every day
Impairs function

5. Diagnosis III
Co-occurring:
Anxiety
Substance abuse
Eating Disorders
ADHD
Impulse Control Disorders
Conduct Disorders
Autism
Tourette’s Disorder
Diabetes
Migraines
Rule Out:
Schizophrenia & Psychotic
Disorders: No psychosis
except when depressed
Depressive Disorders: Anti-
depressants will not trigger
anxiety or mania

6. Find Out
Family history
 Clearest connection of all mental
disorders
Symptomology development
Affective functioning
Cognitive functioning
Substance history
Trauma and loss history
Chart moods

7. Treatments
1. Medication
Mood-stabilizing like Lithium
(useless against mania, and toxic
side effects)
Anti-psychotic, like Lamotrogine,
or anti-convulsants, like
Olanzapine
Can reduce manic phase from
months to days
Avoid antidepressants, which
trigger anxiety and mania
2. Therapies
CBT Cognitive
Behavioral Therapy
Behavioral family
therapy
IPSRT Interpersonal
Social Rhythm
Therapy
Reducing expression
of intense feelings
FFT Family Focused
Therapy

8. Cyclothymia
Alternating
between
hypomanic
symptoms, and
mild or moderate
depressive moods,
like Bipolar II
Less severe,
higher functioning
Bipolar II
1 or more
hypomanic
episodes
(4 days or more),
and no mania
1 or more major
depressive
episodes
(2 weeks or more)
Bipolar I
More severe
1 or more manic
or mixed episodes
Leading to:
Serious problems,
or
Hospitalization,
or
Psychotic
features

10. Diagnosis
More severe
1 or more distinct manic episodes, or mixed
Often with aggression or lack of sexual inhibitions
Often with little sleep or appetite
Leading to:
Serious legal or work problems, or
Hospitalization to avoid harm or
Psychotic features

11. S1. Find Out
Affective functioning
Cognitive functioning
Symptom development
Family history
Trauma history
Substance use
S2. Assess & Refer
Refer for psychological
testing

12. S4.Treatments
1. Medication
Mood-stabilizing like Lithium
(useless against mania, and toxic
side effects)
Anti-psychotic, like Lamotrogine,
or anti-convulsants, like
Olanzapine
Can reduce manic phase from
months to days
Avoid antidepressants, which
trigger anxiety and mania
2. Therapies
Psychoeducation
CBT Cognitive
Behavioral Therapy
Behavioral family
therapy
Interpersonal Social
Rhythm Therapy
Reducing expression
of intense feelings

13. S5. Monitoring
1. Mood charting
2. Monitoring problematic
behavior
3. Affective functioning
4. Medication compliance
S6. Termination
Medication monitoring for
compliance and side effects
Psychotherapies
Support group

15. Diagnosis
1 or more hypomanic episodes (4 days or more),
and no mania
1 or more major depressive episodes (2 weeks or more)

17. Diagnosis
Symptoms
Alternating between elevated
mood (hypomanic symptoms),
and mild or moderate depressive
moods, like Bipolar II
Less severe symptoms and
higher functioning than Bipolar
Disorder I or II
S1. Assessment
Family history
Rule Out
Sleep problem

18. S5. Treatment
Therapy
Interpersonal and Social Rhythm
Therapy (IPSRT)
Family Focused Therapy (FFT)
Cognitive Behavioral Therapy
Group Therapy
Also
Career counseling
Interpersonal skill
Group counseling
Medications
Mood stabilizers, like
Lithium
Anti-seizure or
anticonvulsants, like
Depakote
Antipsychotics, Seroquel
or Risperdal
Anti-anxiety, like
benzodiazepines
Avoid Antidepressants,
which trigger mania

19. S4. Goals of Treatment
1.Decrease risk of developing into bipolar disorder
2.Reduce the frequency and severity of symptoms
3.Prevent a relapse of symptoms, through maintenance
treatment
4.Treat alcohol or other substance abuse problems, since they
can worsen cyclothymia symptoms