THE EVOLVING BIPOLAR SPECTRUM : Prototypes I, II, III, and IV - 07/09/11

Doi : 10.1016/S0193-953X(05)70093-9

Hagop S. Akiskal, MD ^{^{*
International Mood Center, Department of Psychiatry, University of California at San Diego, La Jolla, California}}, Olavo Pinto, MD ^{^{*
International Mood Center, Department of Psychiatry, University of California at San Diego, La Jolla, California}}

Résumé

This article describes the bipolar spectrum in a historical^{32 Kraepelin E. Manic-Depressive Insanity and Paranoia Edinburgh: ES Livingstone (1921).

Cliquez ici pour aller à la section Références} and conceptual context,^{2 Akiskal H.S. The bipolar spectrum: New concepts in classification and diagnosis Psychiatry Update: The American Psychiatric Association Annual Review Washington, DC: American Psychiatric Press (1983).
271-292

Cliquez ici pour aller à la section Références} then provides clinical descriptions for subtypes within this spectrum. Through case material, the authors illustrate how phenomenologic nuances can be used in support for diagnostic subtyping within this spectrum and how such subtyping could provide a more rational approach to mood stabilization in these patients. The prototypes provided should be seen as an attempt to map this vast clinical territory, rather than as definitive subclassification of bipolar spectrum disorders. For fuller description—and for much of the evidence supporting the concept of a bipolar spectrum—the reader is referred to earlier work by the authors.^{2 Akiskal H.S. The bipolar spectrum: New concepts in classification and diagnosis Psychiatry Update: The American Psychiatric Association Annual Review Washington, DC: American Psychiatric Press (1983).
271-292

Cliquez ici pour aller à la section Références, 4 Akiskal H.S. The prevalent clinical spectrum of bipolar disorders: Beyond DSM-IV J Clin Psychopharmacol 1996 ; 17 (suppl 3) : 122S-117S

Cliquez ici pour aller à la section Références, 5 Akiskal H.S., Akiskal K. Re-assessing the prevalence of bipolar disorders: Clinical significance and artistic creativity Psychiatr Psychobiol 1988 ; 3 : 29s-36s

Cliquez ici pour aller à la section Références, 6 Akiskal HS, Brown SF, Pinto O: Emerging epidemiologic and clinical data on the bipolar spectrum. Current Psychiatric Reports (in press)

Cliquez ici pour aller à la section Références}

Le texte complet de cet article est disponible en PDF.

Plan

FROM KRAEPELIN TO DSM-V

BIPOLAR I: FULL-BLOWN MANIA

BIPOLAR I½: DEPRESSION WITH PROTRACTED HYPOMANIA

BIPOLAR II: DEPRESSION WITH HYPOMANIA

BIPOLAR II½: CYCLOTHYMIC DEPRESSIONS

BIPOLAR III: ANTIDEPRESSANT-ASSOCIATED HYPOMANIA

BIPOLAR III½: BIPOLARITY MASKED—AND UNMASKED—BY STIMULANT ABUSE

BIPOLAR IV: HYPERTHYMIC DEPRESSION

CONCLUSIONS

Address reprint requests to Hagop S. Akiskal, MD, Department of Psychiatry, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093–0603, e-mail: hakiskal@ucsd.edu