A 25 year old woman is brought in by her roommate because she's "acting weirdly." But the patient denies this. "I feel better than ever," she says. "I'm invincible, I'm awesome, I only need four hours of sleep each night, and that's not even counting the sex, and even though I'm not getting to my job on time, I have all these projects I'm working on, and I have to go shopping, and sure, my friends can't stand me, but they couldn't before anyway when I was all moody and mopey and dopey and down, but that's okay, now I'm happy just going to the gym and working out for 3 hours a day, and besides, this has happened to me once before, a couple years ago, when all of a sudden I decided to quit school and go on a road trip and see the world, and all my friends thought I was tripping, ha, isn't that a good pun? but really I've never taken any drugs or seen a doctor, I'm healthy like that, and ooh, that's shiny." She points at a plaque you won for diagnostic acumen.
Challenge: Making the right diagnosis is important because the rate of suicide attempts is 25-50% (15% die of suicide) in this condition...what is it?
Monday, November 16, 2009
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3 comments:
Bipolar disorder 1- Mania +/- Major Depressive Illness.. Mania characterised by - euohoria, flight of thoughts, talkativeness, insomnia/ hyperactivity, indulgence in sex (all present in this patient).
Also, history of past depressive illness (may be reliable in this patients case) from the patient herself.
bipolar disorder
:)
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Electrode
This is bipolar disorder; type I involves mania and type II involves hypomania (abnormal mood elevation without serious impairment of function or need for hospitalization).
Source: UpToDate.
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