i have not come across a patient with Bipolar Disorder having only Manic episodes, but have read literature relevant to Unipolar Mania. In professional practice, has anyone come across a patient who has recurrent Manic episodes sans depressive episodes? Or is anyone conducting research in this area?
My understanding is that research suggests up to 1/3 of individuals with bipolar disorder have so-called unipolar mania; no cites off hand. They are less likely to present for treatment, so you are less likely to see them. I have come across some in evaluating potential research participants.
That's not a question I can answer per say as I have nothing to do with the development of the DSM... But if you want to create a list of the flaws in our psychiatric nosological systems, it will be a very long list...
Agreed, but it was a genuine query. Is it because we latently do assume that bipolarity is inherent to mood disorders with a manic component?
An article just published online reviews this topic.
Yazıcı O. Unipolar Mania: A Distinct Entity? J Affect Disord. http://www.sciencedirect.com/science/article/pii/S0165032713007349
Dear colleagues, I believe that the article cited by Professor Young is a very good source of information about this theme.
Well, mania determine the bipolar diagnostic wen excluded organic and drug induced symptoms - this is very problematic in isolated, recurrent and chronic symptoms. Another concern is the over-diagnostic in hyperthymic temperament or personality traits wen used structured interviews without follow-up.
Mania as a disease, can be better identified examining family history of bipolar disorder.
Anyway, until proved other wise: mania should be identified and treated as a type I bipolar disorder.
Eduardo
I always thought that what appears as unipolar mania actually masks what is termed here (USA) as "agitated depression" (a perfectly valid entity in my judgment). If what is being asked in the thread takes this into account, I would answer, from a theoretical point of view, that unipolar mania does not, because cannot, exist as a clinical entity. Behavior redolent of such -- appearing as if unipolar mania -- is essentially what others will term hypomania or some equivalent. I have suggested 'bipolar personality' to cover this territory, which will, however, as often as not include depressive episodes (equivalently, exposure-avoidance behavior/feelings).
Dear Charles, thank you for your input. Could you elaborate on the "bipolar personality" please? The connotation is that it is a ore stable aspect of the individual and not episodic as mood disorders are
Dear Haniska
Your interpretation of the designation is entirely correct. I personally (as a theorist, not a clinician) see four relevant categories: 1) Normal - Standard; 2) Normal - bipolar personality, 3) Disorder - Condition, and 4) Disorder - Disease. A Bipolar Personality indicates the identifiable constellation of traits that, were they much more frequent and/or severe, would become a disordered state. This should not be thought to rise to the level of what some term 'personality disorders'. The Disorder-Condition is a level of trait presentation able to offer personal difficulties, primarily in interpersonal relations and/or in distress sufficient to seek help (a rare occurrance). The Disorder-Disease is a frank and readily identifiable loss of rational control of life as those who know pt well could recognize (though it can be difficult to contact those or get truthful information from them). This last stage will frequently present the dispositive characteristics for disability status (in the US).
See my contribution page and look for the bipolar article mentioning need for additional research in the title.
Thanks
Dear collegues,
I'd appreciate your comments a new theory about the origin of the most common mental diseases. This theory also leads to an approach to discriminate physiologically between MD and UP. What do you think?
https://www.researchgate.net/profile/Ingo_Schymanski/?ev=hdr_xprf
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