Bipolar disorder: At the extremes

摘要

As is the case with many psychiatric diagnoses, bipolar disorder looks simple enough from a distance. Emil Kraepelin's division of mental illness into relapsing and remitting mood disorders, and chronic, deteriorating psychotic conditions, rang true with 19th-century clinicians. This description was followed by an expansion of diagnostic categories, today embodied in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), and the mental and behavioural disorders section of WHO's International Classification of Diseases (ICD). This increasingly complex classification has, to its supporters, led to advances in both research and the ability of clinicians to advise patients accurately about prognosis and treatment.