Bipolar affective disorder Lasix

Upset that qualify previously as manic-depressive psychosis. The disease is characterized by recurrent (at least two) episodes in which mood and level of motor activity significantly violated - from manic to depressive inhibition of hyperactivity Exogenous factors do not affect the rhythm. The boundaries are defined by the transition in episodes episode opposite or mixed polarity, or in the intermission (remission). Attacks have a tropism for seasonal, usually spring and autumn exacerbation, although certain individual rhythms. Duration intermission from 6 months to 2-3 years. The duration of manic states from month to 4 months for the dynamics of the disease of depression last from months to 6 months. Relapses can be approximately the same length, but can be extended by shortening remission. Depression are clearly endogenous in nature: daily fluctuations in mood, vitality elements. In the absence of treatment episodes tend to spontaneous breakage, though they are more prolonged.

As the disease is sometimes observed social decline.

Case example: A patient B., 32 years old, on a specialty dentist. The first episode of mood change was observed in the spring four years ago. He stopped going to work, felt a sense of melancholy, suicidal thoughts, and there were ideas of self, refused to eat. He took a leave of absence, and two weeks later was released from a state of depression for the next year in the spring saw the opposite state. Lots and productive work, little sleep, increased energy, and there was a set of plans that have been successfully implemented. At the height of the state demanded that the head of the clinic to allow him to "night work" to conduct special investigations, quarreled with co-workers, in the morning to come to work drunk. When visiting an outpatient psychiatrist refused treatment and hospitalization. Manic episode lasted two weeks and was repeated in exactly one year. At this time, the patient was persuaded to take drugs lithium and the condition has stabilized during the year. Last - depressive - episode again in the spring, but it becomes protracted. Fired, inactive. Hard to suffer from their inferiority. He thinks it's all over. He complains of feeling "stone chest," a lack of air during inspiration, is not desirable, "the food falls into the void." Against this background, it begins to drink alcohol, but it only deepens the state of anguish. Requests from a friend to give him a gun, "to hunt", trying to commit suicide again. When viewed from the subordination posture fold Veraguta, sad sighs, holding his chest. He believes that to treat it is not necessary, it is better to die in peace. He tells about dreams, which sees in the underground corridors of the dead. He notes that when looking at the others, it seems that they are moderates. Time passes slowly, as if eternity. By evening, the state is somewhat improved.

Based on the identification of recurrent episodes of mood changes and the level of motor activity in the following clinical variants. When diagnosing note directly observed episode of affective disorders, such as hypomanic, manic without psychotic disorders or a psychotic disorder, moderate or mild depression, severe depression with or without psychotic him. If the disorder is not marked, indicated a diagnosis of remission, which is often associated with preventive therapy.

Differential diagnosis

Bipolar disorder is more likely to differentiate with schizoaffective disorder. Schizoaffective disorder is transient endogenous functional disorder, which is also accompanied by almost no defect and which accompany affective disorders and proceed longer than productive symptoms of schizophrenia (F20). These symptoms are not typical for bipolar affective disorder.