The Bipolar Disorder Concept From Kraepelin to DSM-V Flavio Guzmán, MD

Outline The “manic-depressive insanity” concept (Emil Kraepelin) The unipolar vs bipolar distinction (Karl Leonhard) From manic depressive illness to bipolar subtypes (DSM-II to DSM-5)

Emil Kraepelin: manic-depressive insanity Classification Dementia praecox Schizophrenia (Bleuler) Manic-depressive insanity Mood disorders Periodic or episodic nature Relatively benign prognosis Family history of MDI Yildiz, A. (n.d.). (2015).The bipolar book: History, neurobiology, and treatment. (1st ed.). New York, N.Y.: Oxford University Press.

Karl Leonhard: the unipolar vs bipolar distinction Manic-depressive insanity Bipolar Personal history of: Mania+ Depression Family history Unipolar Personal history of: Depression Yildiz, A. (n.d.). (2015).The bipolar book: History, neurobiology, and treatment. (1st ed.). New York, N.Y.: Oxford University Press.

DSM-II and DSM-III DSM-II Manic-depressive illness DSM-III Bipolar Disorder Major Depressive Disorder Recurrent depression? Manic-depressive illness DSM-II Manic-depressive illness Goodwin, F., & Jamison, K. (2007). Manic-depressive illness: Bipolar disorders and recurrent depression (2nd ed.). New York, N.Y.: Oxford University Press.

Bipolar disorder in DSM-IV Inclusion of bipolar II disorder Definition of rapid cycling Definition of mixed episodes Exclusion of antidepressant-induced mood states Goodwin, F., & Jamison, K. (2007). Manic-depressive illness: Bipolar disorders and recurrent depression (2nd ed.). New York, N.Y.: Oxford University Press.

Bipolar disorder in DSM-5 Changes in activity and energy Criterion A Mania or hypomania + mixed features Bipolar depression + mixed features MDD + mixed features Mixed specifier (replaces mixed episode) Anxious stress specifier New specifier Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.

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