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IDENTIFYING AND MANAGING PATIENTS WITH MIXED STATES IN BIPOLAR DISORDER

POSTTEST QUESTIONS

Select the single-letter response that best answers the question, and complete the answer key on the Request for Credit. 1. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), which of the following patients with bipolar disorder meets criteria for a mixed episode? a. A patient with depressed mood and irritability superimposed on hypomania b. A patient with hypomania combined with a full major depressive episode lasting 4 days c. A patient with full syndromal depression every day during a weeklong full manic episode d. A patient with psychotic features during a major depressive episode 4. You are considering the diagnosis of dysphoric mania in a patient with bipolar disorder. Which of the following features is characteristic? a. Male predominance b. Frequent occurrence of typical manic symptoms such as elation and grandiosity c. Irritability d. Lower prevalence of psychotic features

2. Which of the following should be taken into account when considering the diagnosis of dysphoric (depressive) mania in a patient with bipolar disorder? a. The most common clinical presentation involves few depressive symptoms superimposed on mania b. DSM-IV criteria require 2 depressive symptoms during a manic episode c. Dysphoric mania is associated with lower recurrence rates than pure mania d. Dysphoric mania is associated with lower prevalence of medical comorbidities, particularly thyroid dysfunction, than pure mania

5. Based on evidence of poor response, which of the following pharmacologic agents might you be reluctant to prescribe in a patient with depressive symptoms during a manic episode? a. Lithium b. Anticonvulsants c. Atypical antipsychotics d. Antidepressants

6. Which of the following should be considered in the management of patients with mixed states? a. Patients rarely require combination therapy b. Adverse events associated with pharmacologic treatment are more common than in patients with pure states c. Extensive clinical data are available demonstrating efficacy of pharmacotherapies d. Mixed states are easily distinguished from other psychiatric illnesses

3. If a patient with bipolar disorder presents with a mixed state, which of the following should be considered in management? a. Patients with mixed states have a higher risk for suicide than patients with pure states b. Patients with mixed states are typically older at illness onset compared with patients with pure states c. This would be an unusual situation, since mixed states occur in less than 10% of patients d. Patients with mixed states have better clinical outcomes than patients with pure states

SCI-PSY-1137

IDENTIFYING AND MANAGING PATIENTS WITH MIXED STATES IN BIPOLAR DISORDER

EVALUATION FORM

Identifying and Managing Patients With Mixed States In Bipolar Disorder

SciMed respects and appreciates your opinion. To assist us in evaluating the effectiveness of this activity and to make recommendations for future educational offerings, please take a few minutes to complete this evaluation form and fax it to 212-661-8338, ATTN: CME Department.

Extent to which activity met identified objectives

Did this activity help you to: 1) Recognize mixed symptoms in patients with bipolar disorder? 2) Describe the impact of mixed symptoms on the course of bipolar illness? 3) Develop effective treatment strategies for patients with bipolar mixed states? YES YES YES NO NO NO

4) When thinking about the specific learning objectives for this activity (above), what, if anything, are you going to do differently in your practice?

5) If you are not intending to make changes, is this because the activity reaffirms how you currently practice? 6) If you are notintending to make changes, is this because there are barriers in your practice that may prevent your implementing what you have learned? 7) If applicable, describe any barriers to implementing what you have learned.

YES YES

NO NO

8) Please provide any additional feedback on why this activity will not change your management of patients with bipolar disorder.

9) What specific challenges do you encounter in your practice that can be addressed through educational activities on bipolar disorder?

10) Did you perceive any commercial bias* in this activity?

* Commercial bias is defined as a bias for any specific product, device, or procedure without regard to the evidence presented and based solely on the relationship of the speaker/author with the manufacturer of the product, device, or procedure.

YES

NO

11) If you answered "Yes," please note what gave you the impression of commercial bias.

12) Do you have any additional feedback for us on this educational activity?

SCI-PSY-1137

IDENTIFYING AND MANAGING PATIENTS WITH MIXED STATES IN BIPOLAR DISORDER

REQUEST FOR CREDIT

If you wish to receive acknowledgment for participating in this activity, please complete the posttest (select the best answer to each question), along with this evaluation form verifying your participation. The posttest and evaluation form can be faxed to 212-661-8338, ATTN: CME Department. In compliance with AMA policy, a minimum passing score is required. Only participants who meet the minimal passing score will receive CME credit for participating in this activity. The minimum passing score for this activity is 60% correct.

Posttest answer key

Enter posttest answers: 1.

2.

3.

4.

5.

6.

Participant Information: (PLEASE PRINT CLEARLY)

Last Name

First Name

Degree(s)

Academic Title

Affiliation

Specialty

Address (No PO Boxes, Please)

City

State

ZIP/Postal Code

Mobile Phone

Business Phone

Fax

E-mail

Licensed in

Last 4 digits of your Social Security Number OR AMA ME Number

SciMed is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. SciMed designates this educational activity for a maximum of 0.5 AMAPRACategory1CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. I certify that I have participated in the CME activity entitled Identifying and Managing Patients With Mixed States in Bipolar Disorder.

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SCI-PSY-1137

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