History of the nosologic characterization of bipolar disorder

Abstract

The authors review briefly the history of bipolar disorder from Araeteus of Cappadocia to our times. The modern concept of bipolar disorder was built in France, through the work of Falret (1851) and Baillarger (1854). The pivotal concepts of Emil Kraepelin changed the basis of psychiatric nosology, and Kraepelin's unitary concept of manic-depressive insanity was largely accepted. Kraepelin and Weigandt's ideas on mixed states were a cornerstone to this unitary concept. After Kraepelin however, the ideas of Kleist and Leonhard, in Germany, and the work of Angst, Perris and Winokur emphasized the distinction between unipolar and bipolar forms of depression. More recently the emphasis changed again to the bipolar spectrum, which expanded to the borders of the normal temperaments (Akiskal and co-workers). At the end the authors summarize the controversies concerning the nosology of bipolar disorder and its boundaries with schizophrenia, schizoaffective disorders and cycloid psychosis.