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Klerman's and Akiskal's definitions

Posted by Clarinette on October 28, 2004, at 20:11:13

In reply to How many bipolars catatagoies are there?, posted by AntiTrust on October 28, 2004, at 19:18:43

Hello Antitrust,

Here are two of the main classifications of Bipolar Disorder :

**************************************************

KLERMAN'S PRIMARY BIPOLAR SUBTYPES

(Psychiatric Annals #17: January 1987)

Bipolar I: Mania and depression
Bipolar II: Hypomania and depression
Bipolar III: Cyclothymic disorder
Bipolar IV: Hypomania or mania precipitated by antidepressant drugs
Bipolar V: Depressed patients with a family history of bipolar illness
Bipolar VI: Mania without depression [unipolar mania]


Today's leading conceptual thinker in the area of bipolar subtyping is Hagop Akiskal. A fastidious researcher and an astute clinical observer, Akiskal is a devotee of Kraepelin. He believes that the nosologic (classification) pendulum is gradually swinging back towards the master's original unitary concept of the bipolar spectrum of mood disorders. Akiskal's description of the bipolar subtypes differs from that of Klerman. Thus far he has developed four of six proposed subtypes, each one further subdivided according to some unique clinical features. A brief summary of his proposed subtype schema is as follows:

AKISKAL'S SCHEMA OF BIPOLAR SUBTYPES

(Psychiatric Clinics of North America 22:3, September 1999)
Bipolar I: full-blown mania
Bipolar I ½: depression with protracted hypomania
Bipolar II: depression with hypomanic episodes
Bipolar II ½: cyclothymic disorder
Bipolar III: hypomania due to antidepressant drugs
Bipolar III ½: hypomania and/or depression associated with substance use
Bipolar IV: depression associated with hyperthymic temperament


Proposed subtypes V and VI have not yet been characterized, but presumably they will involve episodic anxiety disorders and/or seasonal mood states as well as mood disorders co morbid with various anxiety disorders of an episodic nature.

**************************************************

The information comes from the following link :

http://www.psycom.net/depression.central.lieber.html

You could also look into the DSM-IV for another point of view.

Hope this answers your question,
Bises,
Clara


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