Sample interview questions: How do you approach assessing and managing patients with bipolar and related disorders, such as cyclothymic disorder or substance/medication-induced bipolar and related disorder?
Sample answer:
1. Comprehensive Assessment:
– Gather detailed history, including:
– Symptoms: Mania, hypomania, depression, mixed episodes, rapid cycling
– Course of illness: Onset, duration, frequency, severity, patterns
– Comorbid conditions: Medical, psychiatric, substance use
– Psychosocial factors: Stressors, life events, relationships
– Family history: Mood disorders, substance use disorders, other psychiatric disorders
2. Diagnostic Evaluation:
– Establish a diagnosis based on DSM-5 criteria:
– Bipolar I disorder: At least one manic or mixed episode
– Bipolar II disorder: At least one major depressive episode and at least one hypomanic episode
– Cyclothymic disorder: Numerous hypomanic and depressive episodes
– Substance/medication-induced bipolar and related disorder: Symptoms due to substance use or medication
3. Differential Diagnosis:
– Rule out other conditions with similar symptoms:
– Schizoaffective disorder
– Major depressive disorder with psychotic features
– Borderline personality disorder
– Attention deficit hyperactivity disorder (ADHD)
– Substance-induced mood disorder
4. Treatment Planning:
– Collaborate with the patient to develop a comprehensive treatment plan:
– Medication: Mood stabilizers, antipsychotics, antidepressants
– Psychotherapy: Cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), family-focused therapy
– Lifestyle interventions: Regular sleep, exercise, healthy diet, stress management
5. Medication Management:
– Consider individual patient factors and symptoms when selecting medication:
– Bipolar I disorder: Lithium, valproate, olanzapine, quetiapine, risperidone
– Bipolar II disorder: Lamotrigine, lithium, valproate, olanzapine, quetiapine
– Cyclothymic disorder: Lamotrigine, lithium, valproate
– Substance/medication-induced bipolar and related disorder: Discontinue the offending substance or medication
6. Psychotherapy:
– Offer psychothera… Read full answer
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