S Nassir Ghaemi1, Shannon Dalley. 1. 1Mood Disorders Program, Tufts Medical Center, Tufts University School of Medicine, Boston, USA.
Abstract
OBJECTIVE: This review aims to address concerns about the potential overinclusiveness and vagueness of bipolar spectrum concepts, and also, concerns about the overlap between bipolar illness and borderline personality. METHOD: Narrative review based on historical and empirical studies. RESULTS: Bipolar disorder (BD) and major depressive disorder (MDD) came to be separate entities with the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III), in contrast to the Kraepelinian manic-depressive insanity (MDI) concept, which included both. The bipolar spectrum concept is a return to this earlier Kraepelinian perspective. Further, very different features differentiate the disease of bipolar illness (family history of bipolar illness, severe recurrent mood episodes with psychomotor activation) from the clinical picture of borderline personality (dissociative symptoms, sexual trauma, parasuicidal self-harm). The term 'disorder' obfuscates an ontological difference between diseases, such as manic-depressive illness, and clinical pictures, such as hysteria/post-traumatic stress disorder/dissociation/borderline personality. CONCLUSIONS: Bipolar spectrum concepts are historically rooted in Kraepelin's manic-depressive illness concept, are scientifically testable, and can be clearly formulated. Further, they differ in kind from traumatic/dissociative conditions in ways that can be both historically and scientifically established.
OBJECTIVE: This review aims to address concerns about the potential overinclusiveness and vagueness of bipolar spectrum concepts, and also, concerns about the overlap between bipolar illness and borderline personality. METHOD: Narrative review based on historical and empirical studies. RESULTS:Bipolar disorder (BD) and major depressive disorder (MDD) came to be separate entities with the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III), in contrast to the Kraepelinian manic-depressive insanity (MDI) concept, which included both. The bipolar spectrum concept is a return to this earlier Kraepelinian perspective. Further, very different features differentiate the disease of bipolar illness (family history of bipolar illness, severe recurrent mood episodes with psychomotor activation) from the clinical picture of borderline personality (dissociative symptoms, sexual trauma, parasuicidal self-harm). The term 'disorder' obfuscates an ontological difference between diseases, such as manic-depressive illness, and clinical pictures, such as hysteria/post-traumatic stress disorder/dissociation/borderline personality. CONCLUSIONS: Bipolar spectrum concepts are historically rooted in Kraepelin's manic-depressive illness concept, are scientifically testable, and can be clearly formulated. Further, they differ in kind from traumatic/dissociative conditions in ways that can be both historically and scientifically established.
Authors: A Carlo Altamura; Massimiliano Buoli; Bruno Cesana; Bernardo Dell'Osso; Gianluigi Tacchini; Umberto Albert; Andrea Fagiolini; Andrea de Bartolomeis; Giuseppe Maina; Emilio Sacchetti Journal: Eur Arch Psychiatry Clin Neurosci Date: 2017-04-01 Impact factor: 5.270
Authors: S Nassir Ghaemi; Jules Angst; Paul A Vohringer; Eric A Youngstrom; James Phelps; Philip B Mitchell; Roger S McIntyre; Michael Bauer; Eduard Vieta; Samuel Gershon Journal: Int J Bipolar Disord Date: 2022-10-13