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Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that each last from days to weeks. If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe, it is called hypomania. During mania, an individual behaves or feels abnormally energetic, happy or irritable, and they often make impulsive decisions with little regard for the consequences. There is usually also a reduced need for sleep during manic phases. During periods of depression, the individual may experience crying and have a negative outlook on life and poor eye contact with others. The risk of suicide is high; over a period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged in self-harm. Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder.
Bipolar I disorder is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most people also, at other times, have one or more depressive episodes, and all experience a hypomanic stage before progressing to full mania.
Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together with lability of affect." During a manic episode, an individual will experience rapidly changing emotions and moods, highly influenced by surrounding stimuli. Although mania is often conceived as a "mirror image" to depression, the heightened mood can be either euphoric or dysphoric. As the mania intensifies, irritability can be more pronounced and result in anxiety or anger.
A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where a disturbance in the person's mood is the main underlying feature. The classification is in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD).
Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses.
The affective spectrum is a spectrum of affective disorders. It is a grouping of related psychiatric and medical disorders which may accompany bipolar, unipolar, and schizoaffective disorders at statistically higher rates than would normally be expected. These disorders are identified by a common positive response to the same types of pharmacologic treatments. They also aggregate strongly in families and may therefore share common heritable underlying physiologic anomalies.
A mixed affective state, formerly known as a mixed-manic or mixed episode, has been defined as a state wherein features unique to both depression and (hypo)mania—such as episodes of depression, with: despair, feelings of worthlessness, uselessness or helplessness anguish, suicidal ideation severe anergy anhedonia decreased motivation including: Work avoidance, school avoidance, asocial, and Asexual. and severe apathy. And episodes of hypomania and mania such as: impulsivity or increased energy, decreased need for sleep, emotional liability, racing thoughts, restlessness or hyperactivity pressure of speech, increased self confidence or grandiosity talkativity or pressured speech and heightened, increased, or sudden onset of irritability—occur either simultaneously or in very short succession.
The Feighner Criteria are a set of influential psychiatric diagnostic criteria developed at Washington University in St. Louis between the late 1950s to the early 1970s.
Samuel Barry Guze was an American psychiatrist, medical educator, and researcher. A graduate of City College of New York and Washington University School of Medicine, he was an influential psychiatrist. He worked at the Washington University School of Medicine in St. Louis for most of his career. In addition to twice serving as department chair, he led the School of Medicine as Vice Chancellor for Medical Affairs (1971-1989).
A spectrum disorder is a mental disorder that includes a range of linked conditions, sometimes also extending to include singular symptoms and traits. The different elements of a spectrum either have a similar appearance or are thought to be caused by the same underlying mechanism. In either case, a spectrum approach is taken because there appears to be "not a unitary disorder but rather a syndrome composed of subgroups". The spectrum may represent a range of severity, comprising relatively "severe" mental disorders through to relatively "mild and nonclinical deficits".
Bipolar II disorder (BP-II) is a mood disorder on the bipolar spectrum, characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for BP-II requires that the individual must never have experienced a full manic episode. Otherwise, one manic episode meets the criteria for bipolar I disorder (BP-I).
What was previously known as melancholia and is now known as clinical depression, major depression, or simply depression and commonly referred to as major depressive disorder by many health care professionals, has a long history, with similar conditions being described at least as far back as classical times.
The Schedule for Affective Disorders and Schizophrenia (SADS) is a collection of psychiatric diagnostic criteria and symptom rating scales originally published in 1978. It is organized as a semi-structured diagnostic interview. The structured aspect is that every interview asks screening questions about the same set of disorders regardless of the presenting problem; and positive screens get explored with a consistent set of symptoms. These features increase the sensitivity of the interview and the inter-rater reliability of the resulting diagnoses. The SADS also allows more flexibility than fully structured interviews: Interviewers can use their own words and rephrase questions, and some clinical judgment is used to score responses. There are three versions of the schedule, the regular SADS, the lifetime version (SADS-L) and a version for measuring the change in symptomology (SADS-C). Although largely replaced by more structured interviews that follow diagnostic criteria such as DSM-IV and DSM-5, and specific mood rating scales, versions of the SADS are still used in some research papers today.
Cyclothymia, also known as cyclothymic disorder, psychothemia / psychothymia, bipolar III, affective personality disorder and cyclothymic personality disorder, is a mental and behavioural disorder that involves numerous periods of symptoms of depression and periods of symptoms of elevated mood. These symptoms, however, are not sufficient to indicate a major depressive episode or a manic episode. Symptoms must last for more than one year in children and two years in adults.
Eli Robins was an American psychiatrist who played a pivotal role in establishing the way mental disorders are researched and diagnosed today.
Hypomania is a mental and behavioral disorder, characterised essentially by an apparently non-contextual elevation of mood (euphoria) that contributes to persistently disinhibited behaviour.
The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) is a semi-structured interview aimed at early diagnosis of affective disorders such as depression, bipolar disorder, and anxiety disorder. There are different versions of the test that have use different versions of diagnostic criteria, cover somewhat different diagnoses and use different rating scales for the items. All versions are structured to include interviews with both the child and the parents or guardians, and all use a combination of screening questions and more comprehensive modules to balance interview length and thoroughness.
Mauricio Tohen is a Mexican American research psychiatrist, Distinguished Professor, and Chairman of the Department of Psychiatry & Behavioral Sciences at the University of New Mexico. Tohen's research has focused on the epidemiology, outcome, and treatment of bipolar and psychotic disorders, and is especially known for innovating the design of clinical trials and the criteria to determine outcome in such diseases. Tohen has edited several books on his specialties. His social awareness has been noted in the promotion of programs to improve mental health care in areas such as substance abuse, bipolar disorder and schizophrenia.
Paula Jean Clayton was an American psychiatrist. She was the first female chairperson of a major psychiatric department in the United States. She is known for destigmatising mental illness, rigorous data driven research methods to study psychiatry, especially depression and bipolar disorder.
References
- ↑ Guze, Samuel B. (1997). "George Winokur, MD, 1925-1996". Archives of General Psychiatry. 54 (6): 574. doi:10.1001/archpsyc.1997.01830180092013. ISSN 0003-990X.
- ↑ Clayton PJ (2006). "Training at Washington University School of Medicine in Psychiatry in the late 1950's, from the perspective of an affective disorder researcher". J Affect Disord. 92 (1): 13–7. doi:10.1016/j.jad.2005.12.032. PMID 16527361.
- ↑ Tsuang Ming T (1999). "George Winokur, M.D. 1925–1996". Am J Psychiatry. 156 (3): 465–466. doi:10.1176/ajp.156.3.465. S2CID 143383911.
- ↑ The Making of DSM-III: A Diagnostic Manual's Conquest of American Psychiatry Hannah Decker, Oxford University Press, 13 June 2013. Chapter 3.
- ↑ Winokur George (1988). "'Cause the Bible Tells Me So". Archives of General Psychiatry. 45 (7): 683–684. doi:10.1001/archpsyc.1988.01800310093012. PMID 3382325.
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