Manic Depressive Insanity and Paranoia

Kraepelin, Emil

doi:10.1097/00005053-192104000-00057

Cited by 1,075 publications

(501 citation statements)

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“…Although possible, this opinion has not been studied or proven. The other perspective, that mood illnesses exist with the occurrence of dozens of mood episodes in a lifetime, is based on over a century of solid scientific research (79). The observation of OCD symptoms during some of those dozens of mood episodes would seem to be more likely related to the ongoing mood illness rather than the intermittent OCD symptoms.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Amerio

Odone

Liapis

et al. 2014

Acta Psychiatr Scand

107

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Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review Amerio A, Odone A, Liapis CC, Ghaemi SN. Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review.Objective: At least 50% of bipolar disorder (BD) patients have an additional diagnosis, one of the most difficult to manage being obsessive-compulsive disorder (OCD). Defining the nosology of BD-OCD comorbidity has important clinical implications, given that treatments for OCD can worsen BD outcomes. Method: A systematic review was conducted on: i) BD-OCD comorbidity lifetime prevalence and ii) on standard diagnostic validators: phenomenology, course of illness, heredity, biological markers, and treatment response. Relevant papers published through March 30th 2013 were identified searching the electronic databases MEDLINE, Embase, PsycINFO, and the Cochrane Library. Results: Sixty-four articles met inclusion criteria. Lifetime comorbidity prevalence was 11-21% in BD patients and 6-10% in OCD patients. Compared to non-comorbid subjects, BD-OCD has a more episodic course of OC symptoms (up to 75% vs. 3%), typically with worsening during depression (78%) and improvement during mania/hypomania (64%), as well as a higher total mean number of depressive episodes (8.9 AE 4.2 vs. 4.1 AE 2.7) and perhaps more antidepressant-induced mania/hypomania (39% vs. 9%). Conclusion: In this first systematic review of BD-OCD comorbidity, it appears that OC symptoms are usually secondary to BD, rather than representing a separate disease. • The evidence so far on BD-OCD nosology-mainly based on the course of illness-supports the view that the majority of cases of comorbid BD-OCD are in fact cases of BD. OC symptoms usually are secondary manifestations of depressive or manic mood episodes.• BD-OCD patients may respond for both groups of symptoms with adequate doses of mood stabilizers and atypical antipsychotics. Because of the risk of worsening BD via SRI-induced mania/hypomania, antidepressants should only be used in a minority of refractory OCD. Considerations• Course of illness is the only diagnostic validator that clearly supports the OCD-BD construct as a subtype of BD. Findings on the phenomenology, heredity, biological markers, and treatment were fragmented and heterogeneous and mainly suggested increased severity of illness or functioning without helping us to answer the nosological question.• The use of retrospective assessment scales with unclear sensitivity in discriminating true ego-dystonic obsessions from depressive ruminations may have biased results toward an overestimation of obsession's prevalence. In addition, small sample sizes, mainly from out-patients units, may have limited the generalizability of the results to a whole community.

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Section: Discussionmentioning

confidence: 99%

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Amerio

Odone

Liapis

et al. 2014

Acta Psychiatr Scand

107

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“…Kraepelin (1921), no entanto, usou "estados depressivos" como uma categoria genérica sob a qual ele incluiu a melancolia simplex, o estupor, a melancolia gravis, a melancolia fantástica e a melancolia delirante. No Reino Unido, esse grupo de distúrbios continuou a ser considerado como "melancolia".…”

Section: O Termo "Depressão"unclassified

“…Esta interessante hipótese clínica não foi totalmente testada. Kraepelin (1921) resolveu o problema do diagnóstico diferencial alegando que não havia diferenças reais entre esses estados: "a insanidade maníaco-depressiva, tal como será descrita nesta seção, inclui por um lado todo o domínio da assim chamada insanidade periódica e circular, por outro lado a mania simples, a maior…”

Section: Os Estados Combinadosunclassified

Melancolia e depressão durante o século XIX: uma história conceitual

Berríos

2012

Rev. latinoam. psicopatol. fundam.

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Este artigo analisa historicamente o background ideológico que tornou possível a transformação da noção de melancolia nos conceitos de depressão e transtorno bipolar, a partir das mudanças médicas e psicológicas ocorridas no decorrer do século XIX. A antiga noção de melancolia foi remodelada e sua transição para a doença depressiva foi facilitada pelo conceito de Iipemania de Esquirol, que, pela primeira vez, enfatizou a natureza afetiva primária da doença. Finalmente, uma vez obtidas as condições conceituais necessárias, a melancolia e a mania foram combinadas no conceito de insanidade alternante, periódica, circular, ou de forma dupla, seus rígidos padrões descritivos foram flexibilizados, tendo culminado este processo na sinopse de Kraepelin.

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“…Since Kraepelin's (1921) early descriptions of pre-morbid personalities, several temperamental factors and dimensions have been investigated empirically as possible signs of vulnerability for depression. Several studies have indicated that high levels of neuroticism are a predictor of later depression (Hirschfeld, Klerman, Lavori, Keller, Griffi th, & Coryell 1989;Kendler, Kuhn, & Prescott 2004).…”

Section: Vulnerability Factors In Depressionmentioning

confidence: 99%