Diagnosis, classification, and differential diagnosis of mood disorders

2020 ◽  
pp. 681-690
Author(s):  
S. Nassir Ghaemi ◽  
Sivan Mauer
Keyword(s):  
Differential Diagnosis ◽  
Scientific Evidence ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Bipolar Illness ◽  
Manic Symptoms ◽  
Manic Depressive ◽  
Biological Aspects ◽  
Depressive Subtypes

This chapter discusses DSM and non-DSM definitions and approaches to mood illness. Before 1980, the concept of manic–depressive illness (MDI) meant both bipolar illness and recurrent unipolar depression. Evidence on diagnostic validators since 1980 has not strengthened that claim and may be interpreted to support the original MDI concept, that is, that bipolar illness and unipolar depression are part of the same overall disease (MDI). As a corollary, the concept of major depressive disorder (MDD) may represent a spectrum of different depressive subtypes: mixed (depression with manic symptoms), melancholic, pure, vascular, and neurotic depression. Each subtype differs from the other, based on diagnostic validators of course, genetics, and biological aspects and/or treatment effects. The scientific evidence for this heterogeneity of MDD appears to weaken the claim dating to DSM-III in 1980 that this condition is a different diagnosis/illness from bipolar disorder. The differential diagnosis of mood conditions is described.

Bipolar disorder

2017 ◽  
pp. 233-252 ◽  
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Mood Stabilizers ◽  
Manic Depressive Illness ◽  
Bipolar Illness ◽  
Manic Depressive ◽  
Additional Section

‘Bipolar disorder’ provides an account of the clinical and scientific aspects of bipolar disorder (‘manic depressive illness’). Identification of varying degrees of mood elevation is critical to the diagnosis of bipolar disorder to allow its distinction from unipolar depression, and the phenomenology and classification of manic states is described in detail. The range of aetiological factors involved in the development of bipolar illness is covered, from genetics and brain structure to psychology and life events. The efficacy of treatments both psychological and pharmacological in bipolar disorder is assessed, including new approaches with psychoeducation, atypical antipsychotic drugs, and anticonvulsant mood stabilizers. An additional section covers the clinically challenging treatment of bipolar depression. The evidence from clinical trials is then placed in the context of good clinical management of both the acute phases of bipolar illness as well as longer-term maintenance treatment.

Treatment of Affective Illnesses

2018 ◽  
pp. 231-272
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
Bipolar Depression ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Bipolar Illness ◽  
Manic Depressive ◽  
Antidepressant Efficacy ◽  
The Common ◽  
Term Benefit

The diagnosis and treatment of affective illnesses are examined. Depressive conditions are characterized in their subtypes, as opposed to the DSM-based broad and heterogeneous “major depressive disorder” (MDD) concept (which includes melancholia, mixed depression, neurotic depression, and vascular depression). Bipolar illness is seen as a subgroup of the larger manic-depressive illness (MDI) concept, which also included unipolar depression. MDI was seen as mania or depression, not mania and depression, as in bipolar illness. The treatment implications of this broader concept of MDI are explored, including: limited antidepressant efficacy in “MDD” and in bipolar depression, leading to the common report of “treatment-resistant” depression; worsening of bipolar illness with antidepressants; limited long-term benefit with dopamine blockers in bipolar illness; and good efficacy with dopamine blockers in mixed depressive states.

scholarly journals “Cade's Disease” and Beyond: Misdiagnosis, Antidepressant Use, and a Proposed Definition for Bipolar Spectrum Disorder

2002 ◽  
Vol 47 (2) ◽  
pp. 125-134 ◽  
Author(s):  
S Nassir Ghaemi ◽  
James Y Ko ◽  
Fred er ick K Goodwin
Keyword(s):  
Depressive Illness ◽  
Spectrum Disorder ◽  
Type I ◽  
Bipolar Spectrum ◽  
Manic Depressive Illness ◽  
Bipolar Illness ◽  
Manic Symptoms ◽  
Bipolar Spectrum Disorder ◽  
Manic Depressive ◽  
Antidepressant Use

The diagnosis and treatment of bipolar disorder (BD) has been in con sis tent and frequently mis under stood in re cent years. To identify the causes of this problem and suggest possible solutions, we under took a critical review of studies concerning the nosology of BD and the effects of antidepressant agents. Both the under diagnosis of BD and its frequent mis diagnosis as unipolar major depressive dis order (MDD) appear to be problems in patients with BD. Under diagnosis results from clinicians' in adequate under standing of manic symptoms, from patients' im paired in sight into mania, and especially from failure to involve family members or third parties in the di agnostic process. Some, but by no means all, of the under diagnosis problem may also result from lack of agreement about the breadth of the bipolar spectrum, beyond classic type I manic-depressive illness (what Ketter has termed “Cade's Dis ease”). To alleviate confusion about the less classic varieties of bipolar illness, we propose a heuristic definition, “bipolar spectrum disorder.” This diagnosis would give greater weight to family history and antidepressant-induced manic symptoms and would apply to non-type I or II bipolar illness, in which depressive symptom, course, and treatment response character is tics are more typical of bipolar than unipolar illness. The role of antidepressants is also controversial. Our review of the evidence leads us to conclude that there should be less emphasis on using antidepressants to treat per sons with this illness.

Brain mechanisms in manic depression

1994 ◽  
Vol 40 (2) ◽  
pp. 303-308 ◽  
Author(s):  
B J Carroll
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Manic Depression ◽  
Manic Depressive Illness ◽  
Manic Depressive ◽  
Clinical Presentations ◽  
Genetic Mechanisms ◽  
Activity Information

Abstract Manic depressive illness (bipolar disorder) is the mood disorder classically considered to have a strong biological basis. During manic depressive cycles, patients show dramatic fluctuations of mood, energy, activity, information processing, and behaviors. Theories of brain function and mood disorders must deal with the case of bipolar disorder, not simply unipolar depression. Shifts in the nosologic concepts of how manic depression is related to other mood disorders are discussed in this overview, and the renewed adoption of the Kraepelinian "spectrum" concept is recommended. The variable clinical presentations of manic depressive illness are emphasized. New genetic mechanisms that must be considered as candidate factors in relation to this phenotypic heterogeneity are discussed. Finally, the correlation of clinical symptom clusters with brain systems is considered in the context of a three-component model of manic depression.

The genealogy of the clinical syndrome of mania: signs and symptoms described in psychiatric texts from 1880 to 1900

2017 ◽  
Vol 48 (10) ◽  
pp. 1573-1591 ◽  
Author(s):  
K. S. Kendler
Keyword(s):  
Signs And Symptoms ◽  
Depressive Illness ◽  
Clinical Syndrome ◽  
Manic Depressive Illness ◽  
Sexual Drive ◽  
Manic Symptoms ◽  
Manic Depressive ◽  
Moral Standards ◽  
Psychological Medicine ◽  
Modern Form

AbstractIn 1800, mania was conceptualized as an agitated psychotic state. By 1900, it closely resembled its modern form. This paper reviews the descriptions of mania in Western psychiatry from 1880 to 1900, when Kraepelin was training and developing his concept of manic-depressive illness. Psychiatric textbooks published 1900–1960 described 22 characteristic manic symptoms/signs the presence of which were recorded in 25 psychiatric textbooks and three other key documents published 1880–1900. Descriptions of mania in these nineteenth century textbooks closely resembled those in the twentieth century, recording a mean (s.d.) of 15.9 (2.3) and 17.0 (2.3) of the characteristic symptoms, respectively (p= 0.12). The frequency with which individual symptoms were reported was substantially correlated in these two periods (r= +0.64). Mendel's 1881 monograph, Kraepelin's first description of mania in 1883 and the entry for mania in Tuke's Dictionary of Psychological Medicine (1892) described a mean (s.d.) of 19 (1.7) of these characteristic symptoms. These descriptions of mania often contained phenomenologically rich descriptions of euphoria, hyperactivity, grandiosity, flight of ideas, and poor judgment. They also emphasized several features not in DSM criteria including changes in character, moral standards and physical appearance, and increased sense of humor and sexual drive. Fifteen authors described key symptoms/signs of mania most reporting elevated mood, motoric hyperactivity and accelerated mental processes. By 1880, the syndrome of mania had been largely stabilized in its modern form. In the formation of his concept of manic-depressive illness, Kraepelin utilized the syndrome of mania as described in the psychiatric community in which he was trained.

scholarly journals The symptom of depression in schizophrenia and its management

2000 ◽  
Vol 6 (3) ◽  
pp. 169-177 ◽  
Author(s):  
Ciaran Mulholland ◽  
Stephen Cooper
Keyword(s):  
Depressive Illness ◽  
Dementia Praecox ◽  
Important Criterion ◽  
Manic Depressive Illness ◽  
The Core ◽  
Manic Depressive ◽  
Affective Symptoms ◽  
Psychological Reaction ◽  
Depressive Subtypes ◽  
Core Symptoms

Depression is a frequently occurring symptom in schizophrenia. While today it is often underrecognised and under-treated, historically such symptoms were the focus of much attention. Affective symptoms were used by Kraepelin as an important criterion with which to separate dementia praecox from manic–depressive illness. Kraepelin also recognised the importance of depression as a symptom in schizophrenia and identified several depressive subtypes of the illness. Mayer-Gross emphasised the despair that often occurs as a psychological reaction to acute psychotic episodes and Bleuler considered depression to be one of the core symptoms of schizophrenia.

The Genetics of Depression and Manic-Depressive Disorder

1989 ◽  
Vol 155 (3) ◽  
pp. 294-304 ◽  
Author(s):  
Peter McGuffin ◽  
Randy Katz
Keyword(s):  
Depressive Disorder ◽  
Family Environment ◽  
Depressive Disorders ◽  
Familial Aggregation ◽  
Unipolar Depression ◽  
Endogenous Depression ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Familial Predisposition ◽  
Manic Depressive

Depressive disorders are more common in the relatives of depressed probands than in the population at large, and there is compelling evidence that the familial aggregation of bipolar disorder and severe unipolar depression is at least partly due to genetic factors. However, the evidence concerning ‘non-endogenous' depression is less clear, and family environment probably plays a stronger role. Much current research is focused on two areas: firstly, the mode of inheritance of manic-depressive illness, with the use of molecular biological techniques to detect and localise major genes; and secondly, the ways in which familial predisposition and environmental insults combine to produce depressive disorder.

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