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History of Bipolar Manic-Depressive Disorder 

History of Bipolar Manic-Depressive Disorder
History of Bipolar Manic-Depressive Disorder

Ross J. Baldessarini

, Jesús Pérez

, Paola Salvatore

, Katharina Trede

, and Carlo Maggini

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date: 28 June 2022

Melancholia and mania were described by ancient medical scholars, sometimes in the same persons. Linkage of the syndromes continued among Greco-Roman, Persian, and Arabic scholars throughout the first and by Europeans in the second millennium CE. Early terms describing a single disorder can be found in 1684 (Bonet: manico-melancholicus) and 1759 (Piquer-Arrufat: affectio melancholico-maniaca). The concept was reiterated by Falret and Baillarger (1854) and broadened by Kahlbaum and Hecker (cyclothymia). Weygandt described manic and melancholic features within a single episode (mixed states). Kraepelin gathered a range of recurrent, mainly affective disorders into a broad concept (manic-depressive insanity) in 1895, contrasted to chronic psychotic disorders (dementia præcox, later schizophrenia). In the mid-20th century, recurrent (unipolar) major depressions were differentiated from those with manic episodes (bipolar I disorder), encouraged in part by new treatments. A syndrome (bipolar II) involving recurrent depressions and hypomania was added in the 1970s. Bipolar disorder was accepted into international nosology (DSM-III) in 1980. The concept has broadened further to include relatively mild mood fluctuations (cyclothymia), recurrent depression with minor hypomanic features (bipolar spectrum), and proposed bipolar-like pediatric syndromes (juvenile bipolar disorder). Current ferment in psychiatric nosology is driven by uncertainties about limits and subtypes among major affective and psychotic disorders and by the need to confront the “phenotype problem” faced by modern biological and therapeutic research in psychiatry.

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