BIPOLAR SPECTRUM DISORDER

The great German neuropsychiatrist, Emil Kraepelin, described what he termed manic-depressive insanity at the end of the nineteenth century. He conceptualized a continuum that included today's DSM-IV subtypes, mixed and rapid cycling states, many of the soft bipolar variations and also episodic depressions. This view prevailed until the 1960's, at which time the creators of the first DSM edition ( DSM-I ) proposed a differentiation between major depression and manic-depressive illness. In later DSM editions, this evolved to the unipolar - bipolar dichotomy. In the 1970's Fieve and Dunner discriminated bipolar I from bipolar II disorder, a seminal event in the evolution of the soft bipolar spectrum. Gerald Klerman was the first to postulate a further subtyping of bipolar disorders in 1981. Klerman's Classification of Primary Bipolar Subtypes is summarized as follows:

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]

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

diagnostic criteria for neuroleptic malignant syndrome

micropsychosis

Mnemonics for Mental State Examination (MSE)

Mnemonics for MSE: ASEPTIC

A- Appearance and Behaviour
S- Speech
E- Emotion [mood and affect]
P- Perception [Hallucination and illusion]
T- Thought content and process
I- Insight and Judgement
C- Cognition

Mnemonics for examination for cognition: GOAL-CRAMP

‘I’d like to start off by asking you a few questions to test your concentration and memory……….'

G- general: Alertness and Co-operation
O- orientation: Time and Place
A- attention: WORLD backwards and Serial Sevens
L- language: Naming and Repetition
C- calculation: Division and Subtraction
R- right Hemisphere Function: Intersecting pentagons and Clock-face
A- abstraction: Proverbs and Similarities
M- memory: Short term and Long-term memory
P- praxis: Wave good-bye and Comb hair

mini mental state examination