{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:06:15Z","timestamp":1765544775303,"version":"3.48.0"},"reference-count":78,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Objectives: The main aim was to evaluate the origin and empirical support of the current diagnostic criteria for (hypo)manic and depressive episodes in BD focusing on their nosological (i.e., is it a real entity?) and diagnostic validity (i.e., how well do the criteria for the category portray the entity?). Methods: A narrative review of relevant textbooks\/reports and articles published in peer-reviewed English-language journals (from the online databases PubMed and PsycInfo), covering the period 1900\u20132024 and using the terms \u201cvalidity\u201d OR \u201cdiagnosis\u201d AND \u201cmanic-depressive\u201d; \u201cmania\u201d; \u201chypomania\u201d; \u201cdepression\u201d; and \u201cmelancholia\u201d was performed. Results: Mania appears to be a valid construct in nosological terms, although its validity in the diagnostic domain requires further research. There are scant and controversial empirical data on the nosological validity of separating hypomania from mania as different episodes. The current concept of bipolar depression combines different forms of episodes (melancholic and non-melancholic, with or without psychosis, recurrent or not) without conclusive evidence that all of them are necessarily part of the illness (i.e., limited nosological validity). Conclusions: The validity of the current definition of BD is limited and should be the focus of future research. A valid definition of BD would improve our ability to understand the pathophysiological basis of the illness and contribute to more tailored therapeutic approaches.<\/jats:p>","DOI":"10.3390\/jpm15120624","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T12:52:31Z","timestamp":1765543951000},"page":"624","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Critical Overview of the Validity of the Current Concept of Bipolar Disorder"],"prefix":"10.3390","volume":"15","author":[{"given":"Diego J.","family":"Martino","sequence":"first","affiliation":[{"name":"National Council of Scientific and Technical Research (CONICET), Buenos Aires C1425FQB, Argentina"},{"name":"Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires 1056, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro G.","family":"Szmulewicz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Birmaher","sequence":"additional","affiliation":[{"name":"Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1517\/17530059.2013.734807","article-title":"Novel biomarkers for bipolar disorder","volume":"7","author":"Teixeira","year":"2013","journal-title":"Expert Opin. Med. Diagn."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.tins.2017.10.006","article-title":"The emerging neurobiology of bipolar disorder","volume":"41","author":"Harrison","year":"2018","journal-title":"Trends Neurosci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1038\/s41588-019-0397-8","article-title":"Bipolar Disorder Working Group of the Psychiatric Genomics Consortium. Genome-wide association study identifies 30 loci associated with bipolar disorder","volume":"51","author":"Stahl","year":"2019","journal-title":"Nat. Genet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1038\/s41398-020-0796-8","article-title":"On the diagnostic and neurobiological origins of bipolar disorder","volume":"10","author":"Charney","year":"2020","journal-title":"Transl. Psychiatry"},{"key":"ref_5","unstructured":"National Institute of Mental Health (2015, June 10). Research Domain Criteria (RDoC), Available online: https:\/\/www.nimh.nih.gov\/research\/research-funded-by-nimh\/rdoc\/index.shtml."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/bdi.12700","article-title":"Modelling mood disorders: An ACE solution?","volume":"20","author":"Malhi","year":"2018","journal-title":"Bipolar Disord."},{"key":"ref_7","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_8","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40345-022-00267-3","article-title":"Clinical research diagnostic criteria for bipolar illness (CRDC-BP): Rationale and validity","volume":"10","author":"Ghaemi","year":"2022","journal-title":"Int. J. Bipolar Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1001\/archpsyc.1978.01770300115013","article-title":"Research diagnostic criteria: Rationale and reliability","volume":"35","author":"Spitzer","year":"1978","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/HRP.0000000000000309","article-title":"Bipolar Depression: A Historical Perspective of the Current Concept, with a Focus on Future Research","volume":"29","author":"Martino","year":"2021","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zachar, P., Stoyanov, D.S.T., Argona, M., and Jablensky, A. (2015). Reality and utility unbound: An argument for dual-track nosologic validation. Alternative Perspectives on Psychiatric Validation, Oxford University Press.","DOI":"10.1093\/med\/9780199680733.001.0001"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1176\/ajp.126.7.983","article-title":"Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia","volume":"126","author":"Robins","year":"1970","journal-title":"Am. J. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1001\/archpsyc.1980.01780190097012","article-title":"The nosologic validity of paranoia (simple delusional disorder). A review","volume":"37","author":"Kendler","year":"1980","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_14","unstructured":"Kendler, K.S., Kupfer, D., Narrow, W., Phillips, K., and Fawcett, J. Guidelines for Making Changes to DSM-V, American Psychiatric Association. unpublished manuscript."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1176\/ajp.152.2.161","article-title":"The validation of psychiatric diagnosis: New models and approaches","volume":"152","author":"Andreasen","year":"1995","journal-title":"Am. J. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1176\/appi.ajp.160.1.4","article-title":"Distinguishing between the validity and utility of psychiatric diagnoses","volume":"160","author":"Kendell","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/wps.20286","article-title":"Against utility","volume":"15","author":"Wakefield","year":"2016","journal-title":"World Psychiatry"},{"key":"ref_18","unstructured":"Leonhard, K. (1957). Classication of Endogenous Psychoses, Irvington."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1600-0447.1966.tb11009.x","article-title":"A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses","volume":"194","author":"Perris","year":"1966","journal-title":"Acta Psychiatr. Scand. Suppl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/bdi.12609","article-title":"Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder","volume":"20","author":"Yatham","year":"2018","journal-title":"Bipolar Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1017\/S0033291716003238","article-title":"The clinical features of mania and their representation in modern diagnostic criteria","volume":"47","author":"Kendler","year":"2017","journal-title":"Psychol. Med."},{"key":"ref_22","unstructured":"Kraepelin, E. (1913). Psychiatrie: Ein Lehrbuch fur Studierende und Arzte, Johann Ambrosius Barth. [8th ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1001\/archpsyc.1973.01750350036007","article-title":"Manic states. A genetic study of early and late onset affective disorders","volume":"28","author":"Taylor","year":"1973","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1097\/00005053-198311000-00006","article-title":"Establishing diagnostic criteria for mania","volume":"171","author":"Young","year":"1983","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1001\/jamapsychiatry.2016.3459","article-title":"Activation in bipolar disorders: A systematic review","volume":"74","author":"Scott","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1192\/j.eurpsy.2020.18","article-title":"The structure of mania: An overview of factorial analysis studies","volume":"63","author":"Martino","year":"2020","journal-title":"Eur. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S0165-0327(01)00437-2","article-title":"Origin and development of concepts of bipolar mixed states","volume":"67","author":"Marneros","year":"2001","journal-title":"J. Affect. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1001\/archpsyc.1973.01750320053009","article-title":"The stages of mania. A longitudinal analysis of the manic episode","volume":"28","author":"Carlson","year":"1973","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_29","unstructured":"Goodwin, F.K., and Jamison, K.R. (2007). Manic Depressive Illness: Bipolar Disorders and Recurrent Depression, Oxford University Press."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0165-0327(01)00441-4","article-title":"Toward a refined phenomenology of mania: Combining clinician- assessment and self-report in the French EPIMAN study","volume":"67","author":"Akiskal","year":"2001","journal-title":"J. Affect. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/S0924-9338(03)00041-5","article-title":"Emotional hyper-reactivity as a fundamental mood characteristic of manic and mixed states","volume":"18","author":"Henry","year":"2003","journal-title":"Eur. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jad.2006.10.027","article-title":"Towards a reconceptualization of mixed states, based on an emotional-reactivity dimensional model","volume":"101","author":"Henry","year":"2007","journal-title":"J. Affect. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Henry, C., M\u2019Bailara, K., Mathieu, F., Poinsot, R., and Falissard, B. (2008). Construction and validation of a dimensional scale exploring mood disorders: MAThyS (Multidimensional Assessment of Thymic States). BMC Psychiatry, 8.","DOI":"10.1186\/1471-244X-8-82"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.psychres.2011.12.003","article-title":"Emotional hyperreactivity as a core dimension of manic and mixed states","volume":"197","author":"Atzeni","year":"2012","journal-title":"Psychiatry Res."},{"key":"ref_35","first-page":"31","article-title":"Heritable factors in the severity of affective illness","volume":"11","author":"Dunner","year":"1976","journal-title":"Biol. Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/0010-440X(82)90064-5","article-title":"Classification of affective disorder subtypes","volume":"23","author":"Dunner","year":"1982","journal-title":"Compr. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1002\/depr.3050010103","article-title":"A review of the diagnostic status of \u201cBipolar II\u201d for the DSM-IV work group on mood disorders","volume":"1","author":"Dunner","year":"1993","journal-title":"Depression"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1399-5618.2007.00561.x","article-title":"Bipolar II disorder: Arguments for and against a distinct diagnostic entity","volume":"10","author":"Vieta","year":"2008","journal-title":"Bipolar Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0004867416641541","article-title":"Why the hype about subtype? Bipolar I, bipolar II\u2014It\u2019s simply bipolar, through and through!","volume":"50","author":"Malhi","year":"2016","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40345-019-0175-7","article-title":"The existential crisis of bipolar II disorder","volume":"8","author":"Gitlin","year":"2020","journal-title":"Int. J. Bipolar Disord."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/acps.12567","article-title":"Are the bipolar disorders best modelled categorically or dimensionally?","volume":"134","author":"Parker","year":"2016","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/acps.13218","article-title":"Refined diagnostic criteria for the bipolar disorders: Phase two of the AREDOC project","volume":"142","author":"Parker","year":"2020","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jad.2020.08.014","article-title":"The bipolar disorders: A case for their categorically distinct status based on symptom profiles","volume":"277","author":"Parker","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/bdi.12567","article-title":"Bipolar II disorder","volume":"19","author":"Dunner","year":"2017","journal-title":"Bipolar Disord."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1177\/00048674211020095","article-title":"Polarised views about bipolar disorder(s): A critique of the 2020 College guidelines for mood disorders","volume":"55","author":"Parker","year":"2021","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0165-0327(02)00322-1","article-title":"Toward a re-definition of subthreshold bipolarity: Epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania","volume":"73","author":"Angst","year":"2003","journal-title":"J. Affect. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"914","DOI":"10.4088\/JCP.v66n0715","article-title":"Optimizing the detection of bipolar II disorder in outpatient private practice: Toward a systematization of clinical diagnostic wisdom","volume":"66","author":"Akiskal","year":"2005","journal-title":"J. Clin. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1176\/appi.ajp.2016.15121509","article-title":"The Phenomenology of Major Depression and the Representativeness and Nature of DSM Criteria","volume":"173","author":"Kendler","year":"2016","journal-title":"Am. J. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1001\/archpsyc.1967.01730200030005","article-title":"Lithium as a prophylactic agent. Its effect against recurrent depressions and manic-depressive psychosis","volume":"16","author":"Baastrup","year":"1967","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/0022-3956(68)90047-2","article-title":"Lithium in psychiatric therapy and prophylaxis","volume":"6","author":"Schou","year":"1968","journal-title":"J. Psychiatry Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s00406-022-01546-x","article-title":"Revisiting the concept of bipolar depression: Comparison of diagnostic validators between melancholic and non-melancholic episodes","volume":"274","author":"Martino","year":"2024","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1097\/NMD.0000000000001553","article-title":"Clinical course in patients with melancholic and nonmelancholic bipolar depression","volume":"210","author":"Martino","year":"2022","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1177\/00048674221133743","article-title":"Neurocognitive function of patients with melancholic and non-melancholic major depressive episodes: An exploratory study","volume":"57","author":"Valerio","year":"2023","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/NMD.0000000000001616","article-title":"Clinical characteristics of melancholic and non-melancholic depressions","volume":"211","author":"Valerio","year":"2023","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jad.2013.01.022","article-title":"Efficacy of olanzapine monotherapy in acute bipolar depression: A pooled analysis of controlled studies","volume":"149","author":"Tohen","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1097\/JCP.0000000000000947","article-title":"Melancholic symptoms in bipolar II depression and responsiveness to lamotrigine in an exploratory pilot study","volume":"38","author":"Peters","year":"2018","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/bdi.12501","article-title":"Defining melancholia: A core mood disorder","volume":"19","author":"Parker","year":"2017","journal-title":"Bipolar Disord."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1399-5618.2011.00972.x","article-title":"Bringing back melancholia","volume":"14","author":"Carroll","year":"2012","journal-title":"Bipolar Disord."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1600-0447.2006.00943.x","article-title":"Melancholia: Restoration in psychiatric classification recommended","volume":"115","author":"Fink","year":"2007","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.psychres.2018.08.077","article-title":"Differential response to lithium between melancholic and non-melancholic unipolar depression","volume":"269","author":"Valerio","year":"2018","journal-title":"Psychiatry Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jad.2020.09.083","article-title":"Melancholia: Dimensional or categorical?","volume":"278","author":"Martino","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1097\/NMD.0000000000001090","article-title":"Melancholia: An attempt at definition based on a review of empirical data","volume":"207","author":"Martino","year":"2019","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1192\/bjp.bp.112.124404","article-title":"Mixed features of depression: Why DSM-5 is wrong (and so was DSM-IV)","volume":"203","author":"Koukopoulos","year":"2013","journal-title":"Br. J. Psychiatry"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jad.2013.08.023","article-title":"Comorbidity of personality disorders in mood disorders: A meta-analytic review of 122 studies from 1988 to 2010","volume":"152","author":"Friborg","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.jad.2020.01.141","article-title":"Prevalence of comorbid substance use in major depressive disorder in com- munity and clinical settings, 1990\u20132019: Systematic review and meta-analysis","volume":"266","author":"Hunt","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.jad.2020.04.056","article-title":"Prevalence of comorbid depression in schizophrenia: A meta-analysis of observational studies","volume":"273","author":"Li","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1034\/j.1399-5618.1999.10107.x","article-title":"A two-illness model of bipolar disorder","volume":"1","author":"Joffe","year":"1999","journal-title":"Bipolar Disord."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.cpr.2004.12.002","article-title":"Distinctions between bipolar and unipolar depression","volume":"25","author":"Cuellar","year":"2005","journal-title":"Clin. Psychol. Rev."},{"key":"ref_69","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_70","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1038\/mp.2013.132","article-title":"Specificity of psychosis, mania and major depression in a contemporary family study","volume":"19","author":"Vandeleur","year":"2014","journal-title":"Mol. Psychiatry"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1038\/mp.2016.64","article-title":"Reexamining associations between mania, depression, anxiety and substance use disorders: Results from a prospective national cohort","volume":"22","author":"Olfson","year":"2017","journal-title":"Mol. Psychiatry"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jad.2015.02.011","article-title":"Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders","volume":"178","author":"Forte","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0165-0327(02)00327-0","article-title":"Refining the evaluation of bipolar II: Beyond the strict SCID-CV guidelines for hypomania","volume":"73","author":"Benazzi","year":"2003","journal-title":"J. Affect. Disord."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1034\/j.1399-5618.2000.20309.x","article-title":"Bipolar disorder during adolescence and young adulthood in a community sample","volume":"2","author":"Lewinsohn","year":"2000","journal-title":"Bipolar Disord."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1017\/S0033291709006138","article-title":"Evidence that bipolar disorder is the poor outcome fraction of a common developmental phenotype: An 8-year cohort study in young people","volume":"40","author":"Tijssen","year":"2010","journal-title":"Psychol. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1177\/070674371205701103","article-title":"Bipolar disorder: The shift to overdiagnosis","volume":"57","author":"Mitchell","year":"2012","journal-title":"Can. J. Psychiatry"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"935","DOI":"10.4088\/JCP.v69n0608","article-title":"Is bipolar disorder overdiagnosed?","volume":"69","author":"Zimmerman","year":"2008","journal-title":"J. Clin. Psychiatry"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"297087","DOI":"10.1155\/2013\/297087","article-title":"Overdiagnosis of bipolar disorder: A critical analysis of the literature","volume":"2013","author":"Ghouse","year":"2013","journal-title":"Sci. World J."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/624\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T12:58:09Z","timestamp":1765544289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":78,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jpm15120624"],"URL":"https:\/\/doi.org\/10.3390\/jpm15120624","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}