Bipolar Disorder I and II MCQ — NEET PG Practice Question | NEETPGAI
Bipolar Disorder I and II
medium
brain Psychiatry
A 32-year-old man with bipolar disorder type I presents with a manic episode. Which is the most common cause of treatment non-adherence in bipolar disorder patients?
A. Cognitive impairment from mood episodes
B. Lack of insight and denial of illness
C. Side effects of antipsychotics alone
D. Excessive cost of medications
Explanation
Most Common Cause of Non-Adherence in Bipolar Disorder
Key Point
Lack of insight (anosognosia) and denial of illness is the single most common reason for treatment non-adherence in bipolar disorder, particularly during manic or hypomanic episodes.
Why Insight Matters
During manic or hypomanic phases, patients often:
Feel euphoric and believe they do not need treatment
Lack awareness of their illness (anosognosia)
Deny that their behaviour is abnormal
Resist medication because they perceive no problem
Clinical Pearl
Anosognosia is a neurobiological feature of bipolar disorder itself—not simply patient "non-compliance." It reflects impaired self-awareness due to the underlying mood disorder pathology.
Comparison of Non-Adherence Factors
Table
Factor
Frequency
Modifiability
Lack of insight
Most common
Difficult; improves with mood stabilization
Medication side effects
Common
Manageable; switch agents or add adjuncts
Cost
Variable (region-dependent)
Depends on healthcare system
Cognitive impairment
Less common as primary cause
Improves with mood control
High-YieldNEET PG
In NEET PG exams, when asked about non-adherence in bipolar disorder, the answer is almost always lack of insight, not side effects or cost—these are secondary barriers.
Clinical Management Implication
Addressing non-adherence requires:
1.
Psychoeducation about the illness
2.
Involving family members
3.
Long-acting injectable antipsychotics (LAI) to bypass daily decision-making
4.
Mood stabilization to restore insight
Practice similar questions
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.
