Sign in mental status assessment suggestive of MANIA?

Ans. c (Flights of ideas) (Ref. Ahuja psychiatry 6th/pg. 76)BIPOLAR DISORDER# Definition- A mood disturbance in patient that experiences manic symptoms for > 1 week & cause significant impairment in his/her functioning level.- Bipolar disorder is characterized by unpredictable swings in mood from mania (or hypomania) to depression.# Risk Factors/Epidemiology- Men = Women- Onset in young adults & average age of about 30 years- More prevalent among high socioeconomic status & who didn't finish college- Considered to be the illness with the greatest genetic linkage (50-70%)- Coexisting disorders: Anxiety, Alcohol Dependence & Substance Abuse# Presenting Symptoms- Abnormal or persistently elevated mood lasting > 1 week- | Self-esteem or grandiosity- Excessive involvement in activities & distractibility- Psychomotor agitation & more talkative than usual- Flight of ideas- | Sexual activity- | in goal-directed activity# Some patients suffer only from recurrent attacks of mania, which in its pure form is associated with:- Increased psychomotor activity (including flights of ideas);- Excessive social extroversion;- Decreased need for sleep;- Impulsivity and- Impairment in judgment; and- Expansive, grandiose, and sometimes irritable mood.- In severe mania, patients may experience delusions and paranoid thinking indistinguishable from schizophrenia.- Half of patients with bipolar disorder present with a mixture of psychomotor agitation and activation with dysphoria, anxiety, and irritability.- It may be difficult to distinguish mixed mania from agitated depression.- In some bipolar patients (bipolar II disorder), the full criteria for mania are lacking, and the requisite recurrent depressions are separated by periods of mild activation and increased energy (hypomania).# Treatment:- Pharmacotherapy: Antimanic "Mood Stabilizers" (Lithium, Carbamazepine & Valproic Acid), Benzodiazepines & Antipsychotics.- Lithium is the drug of choice for Acute mania and for Prophylaxis of MDP.QCatatonic-type of schizophrenia is characterized by profound changes in motor activity, negativism, and echolalia or echopraxia.Q