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Should the bipolar disorders be modelled dimensionally or categorically? 

Should the bipolar disorders be modelled dimensionally or categorically?
Chapter:
Should the bipolar disorders be modelled dimensionally or categorically?
Author(s):

Gordon Parker

and Amelia Paterson

DOI:
10.1093/med/9780198748625.003.0002
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date: 23 October 2019

Historically, there have been categorical models of bipolar disorder and dimensional models of bipolar disorder. This chapter seeks to outline the history of these models as well as some recent supporting research. The models are evaluated in two ways; how well they reflect the underlying nature of bipolar disorder, and how useful they are to the patient and to the clinician in undertaking treatment decisions. The dimensional model posits that depression and bipolar lie on a continuum with pure unipolar depression at one end, bipolar disorder at the other, and some experience of highs without diagnosable (hypo)mania in-between. The categorical model posits that depression and bipolar are entirely separate conditions and that bipolar I and II are separate conditions. It is the position of the authors that the categorical model is a better reflection of the underlying nature of bipolar disorder and has proved more useful in clinical practice.

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