Scribd Logo
Upload

Welcome to Scribd!

  • 15 views

    Bipolar Unipolar Dichotomy

    Uploaded by

    Rupinder Gill
    The document discusses the bipolar-unipolar dichotomy in psychiatric classification systems. It describes how Kraepelin originally classified disorders into manic depressive psychosis and dementia praecox. Later classification systems like ICD-11 and DSM-5 separate bipolar disorders from depressive disorders, with bipolar disorders including bipolar type 1, type 2, cyclothymic disorder and others. However, the document argues that there is significant overlap between bipolar and depressive categories, and that many cases originally classified as unipolar depression may be better classified as bipolar.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Bipolar Unipolar Dichotomy

    Uploaded by

    Rupinder Gill
    15 views22 pages
    The document discusses the bipolar-unipolar dichotomy in psychiatric classification systems. It describes how Kraepelin originally classified disorders into manic depressive psychosis and dementia praecox. Later classification systems like ICD-11 and DSM-5 separate bipolar disorders from depressive disorders, with bipolar disorders including bipolar type 1, type 2, cyclothymic disorder and others. However, the document argues that there is significant overlap between bipolar and depressive categories, and that many cases originally classified as unipolar depression may be better classified as bipolar.

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document discusses the bipolar-unipolar dichotomy in psychiatric classification systems. It describes how Kraepelin originally classified disorders into manic depressive psychosis and dementia praecox. Later classification systems like ICD-11 and DSM-5 separate bipolar disorders from depressive disorders, with bipolar disorders including bipolar type 1, type 2, cyclothymic disorder and others. However, the document argues that there is significant overlap between bipolar and depressive categories, and that many cases originally classified as unipolar depression may be better classified as bipolar.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    15 views22 pages

    Bipolar Unipolar Dichotomy

    Uploaded by

    Rupinder Gill
    The document discusses the bipolar-unipolar dichotomy in psychiatric classification systems. It describes how Kraepelin originally classified disorders into manic depressive psychosis and dementia praecox. Later classification systems like ICD-11 and DSM-5 separate bipolar disorders from depressive disorders, with bipolar disorders including bipolar type 1, type 2, cyclothymic disorder and others. However, the document argues that there is significant overlap between bipolar and depressive categories, and that many cases originally classified as unipolar depression may be better classified as bipolar.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    Bipolar – Unipolar Dichotomy

    Dr Rupinder Gill
     He classified nonorganic ‘endogenous’ disorders into 2 main

    Kraeplin’s groups:
    1. Manic Depressive Psychosis (MDP)
    Dichotomy 2. Dementia Praecox
    Leonhard’s
    classification of
    endogenous
    psychosis
     He was able to show that bipolar illness started on an average
    Perris 15 years earlier than depression and recurred more frequently.
    Classifications 1. ICD 11
    used in clinical 2. DSM 5
    practice
     It describes disorders with prominent primary mood symptoms:
    1. Depressive

    ICD 11 2. Manic
    3. Mixed
    4. Hypomanic
     Bipolar disorders

    Block L2 – 6A6  6A60: Bipolar Type 1 disorder


     6A61: Bipolar Type 2 disorder
    Bipolar Type I  Occurrence of 1 or more manic or mixed episodes
    disorder
    Bipolar Type II  Occurrence of 1 or more hypomanic episodes and at least 1
    depressive episode
    disorder
     Depressive disorders
     6A70: Single depressive disorder

    L2 – 6A7  6A71: Recurrent depressive disorder


     6A72: Dysthymic disorder
     6A73: Mixed depressive and anxiety disorder
     Bipolar disorders are separated from depressive disorders
     Bipolar and related disorders include:
     Bipolar I disorder
     Bipolar II disorder

    DSM 5  Cyclothymic disorder


     Substance/medication induced bipolar & related disorder
     Bipolar and related disorder due to another medical condition
     Other specified bipolar & related disorder
     Unspecifed bipolar and related disorder
    1. St. Louis or Feighner criteria
    2. CATEGO

    Classifications 3. RDC

    used in research 4. Leonhard’s system


    5. Winokur’s familial system
    6. Other systems: ICD & DSM for research
     bipolar and depressive disorders can be discriminated clinically
    Dichotomy or and therapeutically

    continuum?  clinical observations testify to a vast overlap between those


    extremes
     50 percent of persons with major depressive disorder during
    long- term prospective follow-up develop hypomanic or manic
    episodes and should be reclassified as having bipolar disorder
     In some, if not many, instances, apparent switching of polarity
    might simply be due to earlier misclassification of bipolar
    disorder as major depressive disorder
     Heterogeneity undoubtedly exists among mood disorders.

     However, the classic unipolar–bipolar distinction might not be


    the best way to capture it.

     The foregoing observations suggest that much of the recurrent


    depressive terrain might be pseudo-unipolar (i.e., soft bipolar).
     The clinical significance of these considerations lies in the fact
    that many DSM-5 subtypes of mood disorders are not pure
    entities, and considerable overlap and switches in polarity take
    place.
     They also provide some rationale, for instance, for why lithium
    or other mood stabilizer augmentation may be effective in some
    apparently unipolar depressions; such patients do not
    necessarily experience brief spontaneous hypomanic episodes
    but instead often exhibit a high baseline level of hyperthymic
    traits.
     Finally, several studies have shown that bipolar patients with
    cyclothymic premorbid adjustment and interepisodic
    adjustment are at considerable risk of antidepressant-induced
    rapid cycling, defined as a rapid succession of major episodes
    with few or no intervals of freedom.
     As Kraepelin illustrated in his monograph, course is best
    captured graphically. Kraepelin, after diagramming 18
    illustrative patterns for the entire spectrum of manic-depressive
    illness, declared that the illness pursued an indefinite number of
    courses.
    Thank You

    You might also like