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

2. 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)

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. End of presentation