By Mario Maj, Hagop S. Akiskal, Juan José López-Ibor Jr., Norman Sartorius
Bipolar sickness is a major psychological disease concerning episodes of significant mania and melancholy and impacts nearly one to 3 percentage of the inhabitants. in line with the nationwide Institute of psychological well-being approximately million contributors within the usa on my own are clinically determined with this illness.
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This can perhaps be inferred from the fact that bipolar disorder following alcohol abuse usually manifests a decade later than bipolar disorder without such abuse ; however, one cannot rule out the possibility that the protracted use of alcohol may have played a formative influence on the bipolar disorder in such cases. Given the clinical dangers of missing an otherwise treatable disorder, bipolar disorder should be given serious consideration as the primary diagnosis if marked bipolar manifestations continue one month after the period of detoxification.
This study needs to be replicated with ``blind'' methodology. The possible inclusion of these ``hyperthymic depressions'' within the bipolar spectrum Ðdepending on the clinical sample and the number of hyperthymic items used for diagnosisÐcould shrink the unipolar depressive universe by 10±20% . However, current data are uncertain about the boundary of hyperthymic temperament and normality. This temperament then, as currently measured, may be considered clinically relevant only in association with major depression [22, 23, 82].
This observation suggests that cyclothymia and bipolar II disorder form a continuum . The same finding emerged in the French EPIDEP study , where 88% of cyclothymes in a national cohort of major depressives were independently diagnosed as bipolar II. In collaboration with a team of clinical researchers from Pisa , we studied 1010, 14±25-year-old students: high internal consistency and diagnostic specificity was found for six of the eight criteria for cyclothymic temperament according to Akiskal and Mallya : lethargy alternating 20 BIPOLAR DISORDER with eutonia; shaky self-esteem alternating between low self-confidence and overconfidence; decreased verbal output alternating with talkativeness; mental confusion alternating with sharpened and creative thinking; unexplained tearfulness alternating with excessive punning and jocularity; and introverted self-absorption alternating with uninhibited people-seeking.