Abstract
1. Mood fluctuations
Bipolar I
Bipolar II
Bipolar III
Borderline personality disorder
Cyclothymia
Dysthymia
Major depressive disorder
Posttraumatic stress disorder
Select the most likely diagnosis related to the following scenarios.
A 22 year old female complains of rapid mood swings within the same day. Her current partner says that she is too sensitive and wants to leave her, but he fears that she will self-harm if he does leave her.
A 58 year old man is in conflict with his wife, because he has bought a large boat and plans to sell their home and sail to the Gold Coast. Twelve months ago, he falsely believed that he was in financial ruin.
A 36 year old teacher complains of low mood, fatigue and early morning wakening. She feels guilty that she hasn’t been able to clean her home and says that only three months ago, she had a few weeks where she felt “really good” and had so much energy she was vacuuming the carpets twice a day. She had lots of great ideas and would wake up at 2am to plan her day’s teaching activities. Apart from this her behaviour was not particularly out of the ordinary.
A 45 year old man with no prior history of mental illness re-presents to his general practitioner two weeks after being prescribed venlafaxine for depression. He reports feeling so well, that he has booked a flight to America tomorrow. He is confident that he can develop and market a revolutionary computer program there.
2. Psychosocial strategies for managing bipolar disorder
Case management
Dialectical behaviour therapy
Establishing a safety plan
Group therapy
Mood chart
Psycho-education
Recognizing early warning signs
Recognizing triggers
Select the first-line psychosocial strategy that would be best recommended in the following scenarios.
A 32 year old woman struggles to understand why her mood gets low at certain times of the month.
Pharmacological management of Bipolar Disorder
3. Which of the following is most consistent with the author’s views regarding the efficacy of lamotrigine in Bipolar Disorder?
It is an efficacious mood stabiliser for patients with Bipolar Disorder
It is an efficacious antidepressant for patients with Bipolar Disorder
It may be an efficacious mood stabiliser in Bipolar II but not Bipolar I
Studies that failed to show a positive effect for lamotrigine in Bipolar Disorder generally used too high a dose
The failure of a number of RCTs to show its effectiveness in managing bipolar disorder limits its usefulness
Continuing Professional Development
In accordance with the RANZCP CPD Program Guide, credit for completing journal reading and related MCQs as CPD activities may be categorised as a Self-guided learning activity under Section 4.4 Informal learning activities. Each hour of participation is awarded one credit. Please keep a verified log of journal readings in case of audit of your CPD annual claim.