Mania

1. MANIA
Dr. Prasanna Prabhakar Khatawkar
M.B.B.S., D.P.M., F.A.G.E., D.N.B. (Psychiatry)
Consultant Psychiatrist
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2. EPISODIC
ILLNESS !!!!!
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3. CLASSIFICATION
• HYPOMANIA
• MANIA WITHOUT PSYCHOTIC
FEATURES
• MANIA WITH PSYCHOTIC FEATURES
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4. OTHER CLINICAL CONDITIONS
• DELIRIOUS MANIA (BELL’S MANIA)
• SECONDARY MANIA
- SWITCH
- CORTICOSTEROIDS
- THYROTOXICOSIS
- TLE
- POST CNS INFECTIONS
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5. CLINICAL FEATURES
• ELEVATED MOOD
• EXPANSIVE IDEAS
• IRRITABILITY
• LABILITY OF MOOD
• INCREASED PSYCHOMOTOR
ACTIVITY
• IMPULSIVITY
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6. CLINICAL FEATURES (cont’d)
• THOUGHTLESS ACTIVITIES
• BUYING SPREES
• PROMISCOUS SEXUAL BEHAVIOURS
• GRANDIOUS AND UNREALISTIC
PLANS
• PRESSURE OF SPEECH
• CLANG ASSOCIATIONS
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7. CLINICAL FEATURES(cont’d)
• FLIGHT OF IDEAS
• PROLIXITY
• GRANDIOUS DELUSIONS
• DELUSIONS OF PERSECUTION
• 2ND PERSON AUDITORY
HALLUCINATIONS
• DECREASED ATTENTION SPAN
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8. CLINICAL FEATURES(cont’d)
• DECREASED NEED FOR SLEEP
• INCREASED SELF-ESTEEM
• INCREASED LIBIDO
• DELUSIONS ARE MOSTLY MOOD
CONGRUENT
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9. DURATION OF EPISODE
• AVERAGE DURATION OF
UNTREATED EPISODE IS
APPROXIMATELY 4 TO 6 MONTHS
• NUMBER OF EPISODES IN LIFE-TIME
( IN B.A.D.) 9 TO 12 EPISODES
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10. DIFFRENTIAL DIAGNOSIS
• SCHIZOPHRENIA
• SCHIZOAFFECTIVE DISORDERS
• MIXED AFFECTIVE STATES
• SUBSTANCE USE-ALCOHOL,
CANNABIS, AMPHETAMINES ETC.
• ORGANIC MOOD DISORDERS
• HYPERTHYMIC PERSONALITY
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11. RAPID CYCLING
• TERM BY DUNNER AND FIEVE
• FOUR OR MORE EPISODES IN ONE
YEAR
• RESPOND WELL TO SODIUM-VALPROATE
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12. MANAGEMENT
• ACUTE STATE :
INJECTABLE ANTIPSYCHOTICS
ORAL ANTIPSYCHOTICS
MOOD STABILIZERS
BEZODIAZEPINES
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13. MANAGEMENT
• LONG TERM MANAGEMENT :
MOOD STABILIZERS
EDUCATION OF FAMILY
IDENTIFY EARLY SIGNS OF RELAPSE
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14. MANAGEMENT
• HOW LONG TO TREAT :
1ST EPISODE - 1 YEAR
2ND EPISODE - 5 YEARS
3RD OR MORE - LIFE-LONG
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15. THANK YOU
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