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Toward next (editions of DSM and ICD) classifications of mixed mania/state (a dipolar, non bipolar, structure/disorder)

Published online by Cambridge University Press:  16 April 2020

E.M. Gonçalves*
Affiliation:
Department of Psychiatry, Hospital of Faro, Faro, Portugal Department of Bioengineering, University of Porto, Porto, Portugal

Abstract

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Bipolar (BI) Disorder (BD) is modelled using limit cycle oscillators, which characterizes its alternating nature: (Pure) (Hypo) Mania (PME) and Depressive Episodes (DE). Also, it is presented, within the mathematical framework designed by René Thom (Catastrophes Theory), the differentiation between BI structures-PME and Dipolar ones (DI)-Mixed Mania/Episode (ME). This differentiation is re-analysed through Ilya Prigogine thermodinamic construct scope of oscillatory systems, with strong fluctuations, and consecutive, emerging, accordingly to chaotic attractors, bifurcated structures. The results, even, at a clinical level, point to different mechanisms underlying BI and DI [PME responds to Lithium Therapy (Lt), contrasting with the poorer response to Lt revealed by Rapid Cycling, ME (and for instances, ethanol withdrawal seizures), which respond to agents that decrease - by quenching (through LTD), even, previously, kindled (through LTP) - the excitability of the implicated brain circuitries (such as anticonvulsive agents, rTMS). It is presented a model of the oscillatory character of NMDA glutamatergic system, within both contexts: BD/BI and ME/DI. in conclusion - detaining PME and ME different conceptual/biophysical, clinical and genetic foundations - it is proposed a revision of the worldwide classifications of Mental Disorders (DSM, ICD), concerning PME versus ME.

Type
Poster Session 1: Eating Disorders
Copyright
Copyright © European Psychiatric Association 2007
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