{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:45:13Z","timestamp":1791193513281,"version":"4.1.0"},"reference-count":65,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2016,7,15]],"date-time":"2016-07-15T00:00:00Z","timestamp":1468540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described \u201cmanic depressive insanity\u201d and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored.<\/jats:p>","DOI":"10.3390\/bs6030014","type":"journal-article","created":{"date-parts":[[2016,7,15]],"date-time":"2016-07-15T11:08:05Z","timestamp":1468580885000},"page":"14","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Historical Underpinnings of Bipolar Disorder Diagnostic Criteria"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1832-1104","authenticated-orcid":false,"given":"Brittany","family":"Mason","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Texas Southwestern Medical Center; Dallas, TX 75390, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Texas Southwestern Medical Center; Dallas, TX 75390, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-6503","authenticated-orcid":false,"given":"Paul","family":"Croarkin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1037\/0033-295X.99.3.561","article-title":"Basic emotions, relations among emotions, and emotion-cognition relations","volume":"99","author":"Izard","year":"1992","journal-title":"Psychol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1080\/02699939408408938","article-title":"Coherence between expressive and experiential system of emotions","volume":"8","author":"Rosenberg","year":"1994","journal-title":"Cogn. Emot."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0165-0327(01)00429-3","article-title":"Bipolarity from ancient to modern times: Conception, birth and rebirth","volume":"67","author":"Angst","year":"2001","journal-title":"J. Affect. Disord."},{"key":"ref_4","first-page":"200","article-title":"Suicide in ancient greece","volume":"25","author":"Laios","year":"2014","journal-title":"Psychiatriki"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0920-9964(02)00328-6","article-title":"Historical aspects of the dichotomy between manic\u2014Depressive disorders and schizophrenia","volume":"57","author":"Angst","year":"2002","journal-title":"Schizophrenia Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S0920-9964(99)00106-1","article-title":"The conflict of the nosologists: Views on schizophrenia and manic-depressive illness in the early part of the 20th century","volume":"39","author":"Jablensky","year":"1999","journal-title":"Schizophrenia Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jad.2011.03.032","article-title":"Kraepelin\u2018s concept of manic-depressive insanity: One hundred years later","volume":"137","author":"Zivanovic","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_8","unstructured":"American Psychiatric Association (1952). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [1st ed.]."},{"key":"ref_9","unstructured":"American Psychiatric Association (1968). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [2nd ed.]."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"218","DOI":"10.4306\/pi.2013.10.3.218","article-title":"Bipolar spectrum: A review of the concept and a vision for the future","volume":"10","author":"Ghaemi","year":"2013","journal-title":"Psychiatry Investig."},{"key":"ref_11","unstructured":"American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [3rd ed.]."},{"key":"ref_12","unstructured":"American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [3rd rev. ed.]."},{"key":"ref_13","unstructured":"American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: Dsm-Iv, American Psychiatric Association. [4th ed.]."},{"key":"ref_14","unstructured":"American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [4th text rev. ed.]."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.jad.2014.09.026","article-title":"The prevalence and illness characteristics of dsm-5-defined \u201cmixed feature specifier\u201c in adults with major depressive disorder and bipolar disorder: Results from the international mood disorders collaborative project","volume":"172","author":"McIntyre","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1001\/jamapsychiatry.2013.2350","article-title":"Boundaries of schizoaffective disorder: Revisiting kraepelin","volume":"70","author":"Kotov","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1038\/mp.2013.173","article-title":"Evidence for separate inheritance of mania and depression challenges current concepts of bipolar mood disorder","volume":"19","author":"Hickie","year":"2014","journal-title":"Mol. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jad.2008.04.022","article-title":"The misdiagnosis of bipolar disorder as a psychotic disorder: Some of its causes and their influence on therapy","volume":"112","author":"Meyer","year":"2009","journal-title":"J. Affect. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1176\/ajp.154.12.1726","article-title":"Clinical and methodological factors related to reliability of the best-estimate diagnostic procedure","volume":"154","author":"Roy","year":"1997","journal-title":"Am. J. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Clementz, B.A., Sweeney, J.A., Hamm, J.P., Ivleva, E.I., Ethridge, L.E., Pearlson, G.D., Keshavan, M.S., and Tamminga, C.A. (2015). Identification of distinct psychosis biotypes using brain-based biomarkers. Am. J. Psychiatry.","DOI":"10.1176\/appi.ajp.2015.14091200"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jad.2016.06.042","article-title":"Differences in symptom expression between unipolar and bipolar spectrum depression: Results from a nationally representative sample using item response theory (irt)","volume":"204","author":"Hoertel","year":"2016","journal-title":"J. Affect. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"151","DOI":"10.31887\/DCNS.2006.8.2\/fbenazzi","article-title":"Various forms of depression","volume":"8","author":"Benazzi","year":"2006","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0193-953X(05)70093-9","article-title":"The evolving bipolar spectrum: Prototypes i, ii, iii, and iv","volume":"22","author":"Akiskal","year":"1999","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/S0165-0327(00)00203-2","article-title":"Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders","volume":"59","author":"Akiskal","year":"2000","journal-title":"J. Affect. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Miller, S., Dennehy, E.B., and Suppes, T. (2016). The prevalence and diagnostic validity of short-duration hypomanic episodes and major depressive episodes. Curr. Psychiatry Rep.","DOI":"10.1007\/s11920-016-0669-2"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.eurpsy.2009.12.025","article-title":"\u201cFolie circulaire\u201c vs \u201cfolie a double forme\u201c: Contribution from a french national study","volume":"26","author":"Azorin","year":"2011","journal-title":"Eur. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1080\/09540260500064744","article-title":"Mixed depressive states: Nosologic and therapeutic issues","volume":"17","author":"Koukopoulos","year":"2005","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jad.2015.01.053","article-title":"Depressive mixed states: A reappraisal of koukopoulos\u2018 criteria","volume":"176","author":"Faedda","year":"2015","journal-title":"J. Affect. Disord"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jad.2004.05.004","article-title":"Atypical depression: A variant of bipolar ii or a bridge between unipolar and bipolar ii?","volume":"84","author":"Akiskal","year":"2005","journal-title":"J. Affect. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1176\/appi.ajp.2013.13020185","article-title":"The international society for bipolar disorders (isbd) task force report on antidepressant use in bipolar disorders","volume":"170","author":"Pacchiarotti","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1056\/NEJMoa064135","article-title":"Effectiveness of adjunctive antidepressant treatment for bipolar depression","volume":"356","author":"Sachs","year":"2007","journal-title":"New Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1176\/appi.ajp.163.2.210","article-title":"Treatment-resistant bipolar depression: A step-bd equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone","volume":"163","author":"Nierenberg","year":"2006","journal-title":"Am. J. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jpsychires.2015.06.015","article-title":"Antidepressant dose and treatment response in bipolar depression: Reanalysis of the systematic treatment enhancement program for bipolar disorder (step-bd) data","volume":"68","author":"Tada","year":"2015","journal-title":"J. Psychiatr. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"126","DOI":"10.5498\/wjp.v5.i1.126","article-title":"Mood spectrum model: Evidence reconsidered in the light of dsm-5","volume":"5","author":"Benvenuti","year":"2015","journal-title":"World J. Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1038\/mp.2013.116","article-title":"Independence of familial transmission of mania and depression: Results of the nimh family study of affective spectrum disorders","volume":"19","author":"Merikangas","year":"2014","journal-title":"Mol. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.chc.2008.11.003","article-title":"The concept of bipolar disorder in children: A history of the bipolar controversy","volume":"18","author":"Carlson","year":"2009","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_38","first-page":"319","article-title":"Our present knowledge about manic-depressive states","volume":"9","year":"1952","journal-title":"Nerv. Child"},{"key":"ref_39","first-page":"326","article-title":"Differential patterns of manic-depressive disease in childhood","volume":"9","author":"Harms","year":"1952","journal-title":"Nerv. Child"},{"key":"ref_40","unstructured":"Crichton, A. (1798). An Inquiry into Mental Derangement II, T. Cadell, Jr. and W. Davies."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1192\/bjp.44.186.459","article-title":"Insanity of children","volume":"44","author":"Beach","year":"1898","journal-title":"J. Ment. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kraepelin, E. (1921). Manic-Depressive Insanity and Paranoia, Livingston.","DOI":"10.1097\/00005053-192104000-00057"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Renk, K., White, R., Lauer, B.A., McSwiggan, M., Puff, J., and Lowell, A. (2014). Bipolar disorder in children. Psychiatry J.","DOI":"10.1155\/2014\/928685"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/0957154X04044083","article-title":"Manic-depressive illness in children: An early twentieth-century view by theodor ziehen (1862\u20131950). Introduction","volume":"15","author":"Baethge","year":"2004","journal-title":"Hist. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1176\/ajp.87.6.897","article-title":"The affective psychoses in children","volume":"10","author":"Kasanin","year":"1931","journal-title":"Am. J. Psychiatry"},{"key":"ref_46","first-page":"209","article-title":"The prognosis in manic depressive psychosis","volume":"114","author":"Strecker","year":"1921","journal-title":"N.Y. J. Med."},{"key":"ref_47","first-page":"319","article-title":"Manic depressive psychosis in childhood","volume":"9","author":"Barrett","year":"1952","journal-title":"Nerv. Child"},{"key":"ref_48","first-page":"27","article-title":"Bradley\u2019s benzedrine studies on children with behavioral disorders","volume":"84","author":"Strohl","year":"2011","journal-title":"Yale J. Biol. Med."},{"key":"ref_49","unstructured":"Abraham, K. (1911). Selected Papers on Psychoanalysis, Oxford University Press."},{"key":"ref_50","unstructured":"Klein, M. (1952). Mourning and Its Elation to Manic-Depressive States, Hogarth Press."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1001\/archpedi.1976.02120050038006","article-title":"Mania in childhood: Case studies and literature review","volume":"130","author":"Weinberg","year":"1976","journal-title":"Am. J. Dis. Child."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1001\/archpediatrics.2011.832","article-title":"Recent progress in understanding pediatric bipolar disorder","volume":"166","author":"Goldstein","year":"2012","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1176\/appi.ajp.2014.13101301","article-title":"Disruptive mood dysregulation disorder: A new diagnostic approach to chronic irritability in youth","volume":"171","author":"Roy","year":"2014","journal-title":"Am. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1176\/appi.ajp.160.3.430","article-title":"Defining clinical phenotypes of juvenile mania","volume":"160","author":"Leibenluft","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1176\/appi.ajp.2007.06101619","article-title":"Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation","volume":"164","author":"Brotman","year":"2007","journal-title":"Am. J. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.biopsych.2006.08.042","article-title":"Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children","volume":"60","author":"Brotman","year":"2006","journal-title":"Biol. Psychiatry"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Wiggins, J.L., Brotman, M.A., Adleman, N.E., Kim, P., Oakes, A.H., Reynolds, R.C., Chen, G., Pine, D.S., and Leibenluft, E. (2016). Neural correlates of irritability in disruptive mood dysregulation and bipolar disorders. Am. J. Psychiatry.","DOI":"10.1176\/appi.ajp.2015.15060833"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1176\/appi.ajp.2012.12070999","article-title":"Dsm-5 field trials in the united states and canada, part ii: Test-retest reliability of selected categorical diagnoses","volume":"170","author":"Regier","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1089\/cap.2008.044","article-title":"Randomized double-blind placebo-controlled trial of lithium in youths with severe mood dysregulation","volume":"19","author":"Dickstein","year":"2009","journal-title":"J. Child Adolesc. Psychopharmacol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jaac.2015.12.011","article-title":"A randomized clinical trial of an integrative group therapy for children with severe mood dysregulation","volume":"55","author":"Waxmonsky","year":"2016","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1037\/a0015919","article-title":"Are there developmentally limited forms of bipolar disorder?","volume":"118","author":"Cicero","year":"2009","journal-title":"J. Abnorm. Psychol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1001\/archgenpsychiatry.2012.38","article-title":"Mania with and without depression in a community sample of us adolescents","volume":"69","author":"Merikangas","year":"2012","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.ijpsycho.2015.06.004","article-title":"Asymmetrical frontal cortical activity associated with differential risk for mood and anxiety disorder symptoms: An rdoc perspective","volume":"98","author":"Nusslock","year":"2015","journal-title":"Int. J. Psychophysiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1176\/appi.ajp.2016.16030347","article-title":"The rdoc controversy: Alternate paradigm or dominant paradigm?","volume":"173","author":"Carpenter","year":"2016","journal-title":"Am. J. Psychiatry"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jaac.2015.11.002","article-title":"The national institute of mental health research domain criteria and clinical research in child and adolescent psychiatry","volume":"55","author":"Garvey","year":"2016","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/6\/3\/14\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:26:15Z","timestamp":1760210775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/6\/3\/14"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,15]]},"references-count":65,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2016,9]]}},"alternative-id":["bs6030014"],"URL":"https:\/\/doi.org\/10.3390\/bs6030014","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,15]]}}}