Manic Depressive Illness


1- maniac Access:

* Excitation state of mental and motor functions

* Insomnia is the earliest symptom

* Presentation: slovenly, extravagant, hypermimie, mannerism, playfulness, grimaces, anger, disgust, passion; wishes of perfect symmetry.

* Contact is hypersyntone familiar

* Cognitive Impairment: hypoprosexie (dispersion of attention); tachypsychia and verbal diarrhea (passage of one subject to another); verbal delirium with megalomaniac note.

* Excitement Psychomotor: sterile agitation and inappropriate; dispersion

* Somatic Disorders: rebellious total sleeplessness; anorexia; hypersexuality; alcoholism; transgression of moral principles

* Sometimes hallucinatory delirium

Manic Depressive Illness2- melancholy Access:

* Start brutal: a few hours or days; spontaneous evolution in 3 to 6 months

* Depressed mood: pessimistic; anhedonia; self-dévalorisaion; moral pain;

* Idea delirious incurability, guilt, self-blame, ruin, persecution

* Affective blunting; instability affects (irritability, impulsivity)

* Psychomotor Slowing (bradypsychia): ideation slow; poor speech; aboulie; catalepsy

* Somatic Syndrome: early morning insomnia; anorexia; decreased libido; somatic complaints

3- Common Symptoms:

– Bipolar I disorder: One or more manic or mixed episodes associated with major depressive disorder

– Bipolar II Disorder: combination of at least one major depressive episode and a hypomanic episode.

– Four Temperaments: hyperthymic, depressive, cyclothymic and irritable (bipolar patient outside the free access and related).

4- Treatment:

* Before the melancholy -> antidepressant Anafranil kind: + graded doses sedative neuroleptics (Nozinan)

* Before the manic: neuroleptic like Haldol or Nozinan

* Between the access: mood stabilizers (lithium or carbamazepine)