<prompt> Sign in mental status assessment suggestive of MANIA?NeologismPerseveranceFlights of ideasEcholalia  <response>: Ans. c Flights of ideas Ref. Ahuja psychiatry 6thpg. 76BIPOLAR DISORDER Definition- A mood disturbance in patient that experiences manic symptoms for 1 week cause significant impairment in hisher functioning level.- Bipolar disorder is characterized by unpredictable swings in mood from mania or hypomania to depression. Risk FactorsEpidemiology- Men Women- Onset in young adults average age of about 30 years- More prevalent among high socioeconomic status who didnt 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 