FIKA TASLIM

201410401011009

NIMH

DSM

Bipolar disorder, also known as manicdepressive illness, is a brain disorder that

causes unusual shifts in mood, energy, activity
levels, and the ability to carry out daily tasks.

Bipolar disorder according to the "Diagnostic

and Statistical Manual of Mental Disorders Text Revision" fourth edition (DSM-IV-TR) is a
mood disorder that consists of at least one
episode of manic, hypomanic, or mixed are
usually accompanied with a history of major
depressive episodes .

Epidemiology
Bipolar incidence in the United States affecting
nearly 5, 7 million people. some surveys Colombia is
done in America, India and Japan me showed that
American Top bipolar disorder by 4.4%, Colombia 2 ,
5%, Japan 0.7% and the lowest in the India 0.1%.
From the data obtained alley Rikesdas 2013 mental
emotional guan including
therein bipolar disorder showed about 6%
of the population in Indonesia.
Prevalence Bipolar events in Indonesia is estimated
affects many people with socio-economic
low.
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biological
factors

genetic
factors

psychoso
cial
factors

 theory of neurotransmitters
Mood disorder caused by an imbalance of
neurotransmitters in the CNS
Excess amine compound (NE and dopamine) ->
mania
shortage NE, dopamine, 5-HT -> depression
Imbalance between the activity / DA and NE ratio
mood changes from depression to mania
If NE down dopamine dominate hipomania switch
or mania
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Symptoms of mania or a manic

episode include:
Mood Changes
An overly long period of feeling
high, or an overly happy or
outgoing mood
Extreme irritability.
Behavioral Changes
Talking very fast, jumping from
one idea to another, having racing
thoughts
Being unusually distracted
Increasing activities, such as
taking on multiple new projects
Being overly restless
Sleeping little or not being tired
Having an unrealistic belief in
your abilities
Behaving impulsively and
engaging in pleasurable, high-risk
behaviors.

Symptoms of depression or a
depressive episode include:
Mood Changes
An overly long period of
feeling sad or hopeless
Loss of interest in activities
once enjoyed, including sex.

Behavioral Changes
Feeling overly tired or
slowed down
Having problems
concentrating, remembering,
and making decisions
Being restless or irritable
Changing eating, sleeping, or
other habits
Thinking of death or suicide,
or attempting suicide.
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Criteria Dx
Mild Depression:
At least 2 of the 3 main symptoms
+ At least 2 of the other symptoms
Little difficulty activities and everyday tasks
Moderate Depression:
At least 2 of the 3 symptoms
+ At least 3-4 other symptoms
Difficult activities and everyday tasks
Depression:
3 main symptoms
+ 4 other symptoms
Unable to activities and everyday tasks
Depression with Psychotic Symptoms
Criteria for Depression
+ Supposition, hallucinations, depressive stupor
(delusions of sin, poor, disaster, hallucinations insults, accusations, the
stench and so on)
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 Manic episode
Mood increased, overflowing
+ Increase in physical activity and mental
hypomania
more light of Mania,> siklotimia
Episode few days
Daily activities disrupted
Mania Without Psychotic Symptoms
Lasting> 1 week
Increased activity, speech, lack of sleep, grandiose, optimistic >>.
Daily activities chaotic
Mania with psychotic symptoms
> Weight of Mania Without Psychotic
Delusions of greatness, irritability, delusions chase.
Delusions and hallucinations = mood congruent
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 Bipolar Affective Disorders

Recurrent episodes (at least 2
episodes)
One moment Mania / hypomania (2
weeks-5 months), while others
Depression (6 months)
There is healing them

GANGGUAN MOOD BIPOLAR

Bipolar I

Bipolar II

Manic or
mixed

Hypoma
nia 4
days

Impairme
nt function
and
symptoms
clear
Usually
with
recurrent
depression

Never
manic or
mixed
recurrent
depression

Bipolar NOS

Siklotimia

Does not
meet the
specific
criteria for
bipolar I or II,
hypomania
<4 days
Usually with
recurrent
depression

2 years
Does not
meet the
criteria for
depression,
manic, or
mixed
episodes
dysthymia

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F30 Manic
Episode

F31 Bipolar
Affective
Disorders

F38
Disturbance.
Other Mood
and F39 are
not classified

F32
Depressive
Episode

F34
Disturbance.
Residential
Mood
F33
Disturbance.
Recurrent
depressive

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Therapy
Anti-mania: Lithium carbonate, Carbamazepine,
haloperidol, olanzapine
Antidepressants:
SSRIs: Fluoxetine, Sertraline, Paroxetine, Fluvoxamine
Tricyclic: Amitriptyline, Imipramine, clomipramine
Tetrasiklik: Maprotiline, Amoxapine, Mianserine
MAOIs: moclobemide
Atypical: Trazodone
ECT: - No response to drugs, - Intolerance, - Clinical
very severe
Psychosocial Therapy / Psychotherapy
MRS: Suicide risk, Homicide, self neglect
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