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Similar to case presentation on mania presented by ajay mor
case presentation on mania presented by ajay mor
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- 3. Presenting complaints •A 23 yrs unmarried right handed Marathi speaking , Hindu religious male ganesh sankpal, educated B.E ,coming from chinchwad pune with the complaints of • Irritability • Wandering behaviour • Muttering to self • Suspiciousness • Loudly speak • Auditory hallucination • Grandiosity • Loss of memory • Increased psychomotor activity • Flight of ideas
- 4. HISTORY OF ILLNESS • According to informant pt is k/c/o/ psychiatric illness since 4 years was remain untreated till now • Patient was shown psychiatric illness in past then he was admitted in hospital 3 years ago but absconded before treatment start since then patient behaviour fluctuatively (having unpredictable ups down )and now as behaviour become unmanageble so he brought to SGH
- 5. HISTORY OF ILLNESS • 4 yrs back his symptoms started within duration of B.E F Y exam period and he was noticed anxious during exam period & he was also noticed to be talking to to self with gesturing of hand when asked him ,then he said its related to study • He was noticed above symptoms with running on road without any reason ,sudden stop going temple and said ringing bell in my ears • All this behaviour increased and told repeatedly about his behaviour and parent brought to SGH • No family history of psychiatric illness
- 6. DEFINATION OF MANIA • Mania refers to a syndrome in which the central features are over activity, mood change (which may be towards elation OR irritability ) and self important ideas
- 8. Classification of mania(ICD 10) • F30 MANIC EPISODE • F30.0 HYPOMANIA • F30.1 MANIA WITHOUT PSYCHOTIC SYMPTOMS • F30.2 MANIA WITH PSYCHOTIC SYMPTOMS • F30.8 OTHER MANIC EPISODE • F30.9 MANIC EPISODE UNSPECIFIED
- 10. ETIOLOGY Neurotransmitter andstructural hypothesis Excessive level of nor epinephrine and dopamine Imbalance between cholinergic and nor adrenergic system and deficiency of serotonin
- 11. Genetic consideration •Monozygotic (identical) twines have a higher rate of incident than normal siblings and other close relatives • Common among the family members of bipolar patient • First degree relatives 5-10 % chance • Identical twins with bipolar disorders about 40-70% chance
- 12. Psychodynamic theory •Developmental theorists have hypothesized that faulty family dynamics during during early life are responsible for manic behaviors in later life Manic episode as a defense against or denial of depression
- 24. Clinical features Inbook • Elevated ,Expansive OR irritable mood • 1)Euphoria • 2)Elation • 3)Exaltation • 4) Ecstasy In patient • Elation and irritable mood • 1) irritability • 2)wandering behaviour
- 25. cont In book • Psychomotor activity increased • Speech and thought • Flight of ideas • Pressure of speech • Delusion of grandiosity • Delusion of persecution • Distractibility In patient • Psychomotor activity increased • Speech and thought • Flight of ideas • Delusion of grandiosity • Big talk • Speak loudly
- 26. cont In book • Other features • increased sociability • Impulsive behaviour • Poor judgment • Decreased sleep • Absence of insight • Decreased attention and concentration In patient • Other features • Poor judgment • Decreased sleep • Loss of memory (amnesia)
- 40. Objective sings andsubjective symptoms of manic patient Objective sings • Disturbance in speech • Rapid speech • Loud ,pressured pressure • Easily distracted • Over activity • Mood lability • Weight change Subjective symptoms • Feeling of joy • Rapid mood swings • Sleep disturbance • Delusion and hallucination