Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-06T09:04:41.408Z Has data issue: false hasContentIssue false

The clinical features of mania and their representation in modern diagnostic criteria

Published online by Cambridge University Press:  19 December 2016

K. S. Kendler*
Affiliation:
Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
*
*Address for correspondence: K. S. Kendler, MD, Virginia Institute of Psychiatric and Behavioral Genetics, Departments of Psychiatry and Human and Molecular Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, Box 980126, Richmond, VA 23298-0126, USA. (Email: [email protected])

Abstract

This review seeks to determine the degree to which modern operationalized diagnostic criteria for mania reflect the clinical features of mania described historically by expert textbook authors. Clinical descriptions of mania appearing in 18 textbooks published between 1899 and 1956 were reviewed and compared to the criteria for mania from six modern operationalized diagnostic systems. Twenty-two prominent symptoms and signs were reported by five or more authors. Two symptoms (elevated mood and grandiosity) and four signs (hyperactivity, pressured speech, irritability, and new activities with painful consequences) were reported by every author. A strong relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern diagnostic systems. However, many symptoms and signs including impulsivity, hypersexuality, mood lability, altered moral standards, increased humor, hypergraphia, and a vigorous physical appearance were not included in any modern criteria. Indeed, DSM-5 contains only eight of the historically noted clinical features. We conclude that modern operationalized criteria for mania well reflect symptoms and signs frequently reported by historical experts. This suggests that the clinical construct of mania has been relatively stable in western Psychiatry since the turn of the 20th century. However, many useful clinical features of mania described in these textbooks are missing from these criteria thereby illustrating the limitations of clinical evaluations restricted to the assessment of only current diagnostic criteria. The disorders we study and treat are considerably richer clinically than is reflected in the DSM criteria which we use to diagnose them.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, Revised 3rd edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. DSM-5. American Psychiatric Association: Washington, DC.Google Scholar
Andreasen, NC (2007). DSM and the death of phenomenology in America: an example of unintended consequences. Schizophrenia Bulletin 33, 108112.Google Scholar
Berrios, GE (1981). The two manias. British Journal of Psychiatry 139, 258261.CrossRefGoogle Scholar
Berrios, GE (1996). The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century. Cambridge University Press: New York, NY.Google Scholar
Berrios, GE (2004). Of mania: introduction (Classic text no. 57). History of Psychiatry 15, 105124.CrossRefGoogle ScholarPubMed
Bleuler, E (1976). Textbook of Psychiatry. Arno Press: A New York Times Company: New York.Google Scholar
Buckley, AC (1920). The Basis of Psychiatry (Psychological Medicine): A Guide to the Study of Mental Disorders, for Students and Practitioners. Forgotten Books: London, 1920 (originally published 1920).Google Scholar
Carlson, GA, Goodwin, FK (1973). The stages of mania. A longitudinal analysis of the manic episode. Archives of General Psychiatry 28, 221228.Google Scholar
Cole, RH (1913). Mental Diseases: A Text-Book of Psychiatry for Medical Students and Practitioners, 1st edn. University of London Press: London.Google Scholar
Craig, M (2013). Psychological Medicine: A Manual on Mental Diseases for Practitioners and Students. Forgotten Books: London, 2013 (originally published 1912).Google Scholar
Curran, D & Guttmann, E (1945). Psychological Medicine: A Short Introduction to Psychiatry, 2nd edn. E. & S. Livingstone LTD: Edinburgh.Google Scholar
Dana, CL (1904). Text-Book of Nervous Diseases and Psychiatry: For the use of Students and Practitioners of Medicine, 6th rev. and enl.ed. ed. William Wood and Company: New York, NY.Google Scholar
De Fursac, R (2013). Manual of Psychiatry Forgotten Books 2013, originally published 1905.Google Scholar
Decker, HS (2013). The Making of DSM-III: A Diagnostic Manual's Conquest of American Psychiatry, 1st edition. Oxford University Press: Oxford, UK.Google Scholar
Feighner, JP, Robins, E, Guze, SB, Woodruff, RA Jr., Winokur, G, Munoz, R (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.CrossRefGoogle ScholarPubMed
Gordon, RG, Harris, NG, Rees, JR (1936). An Introduction to Psychological Medicine. Oxford University Press, Oxford Medical Publications: London.Google Scholar
Healy, D (2008). Mania: A Short History of Bipolar Disorder. Johns Hopkins University Press: Baltimore.Google Scholar
Henderson, DK & Gillespie, RD (1944). A Text-Book of Psychiatry for Students and Practitioners, 6th edn. Oxford University Press; Oxford Medical Publications: London.Google Scholar
Hyman, SE (2010). The diagnosis of mental disorders: the problem of reification. Annual Reviews of Clinical Psychology 6, 155179.CrossRefGoogle ScholarPubMed
Kendler, KS (2014). DSM issues: incorporation of biological tests, avoidance of reification, and an approach to the “box canyon problem”. American Journal of Psychiatry 171, 12481250.Google Scholar
Kendler, KS (2015). The transformation of American psychiatric nosology at the dawn of the twentieth century. Molecular Psychiatry 21, 152158.Google Scholar
Kendler, KS (2016 a). The phenomenology of major depression and the representativeness and nature of DSM criteria. American Journal of Psychiatry 173, 771780.Google Scholar
Kendler, KS (2016 b). The phenomenology of schizophrenia and the representativeness of modern diagnostic criteria 73, 10821092.Google ScholarPubMed
Kraepelin, E (1899). Psychiatrie: Ein Lehrbuch fur Studierende und Aerzte (6th edn, 2 vols.) von Barth Verlag: Leipzig.Google Scholar
Kraepelin, E (1921). Manic-Depressive Illness and Paranoia. E. & S. Livingstone: Edinburgh.Google Scholar
Mayer-Gross, W, Slater, E, Roth, M (1954). Clinical Psychiatry, 1st edn. Cassell and Company Ltd: London.Google Scholar
Muncie, W (1939). Psychobiology and Psychiatry: A Textbook of Normal and Abnormal Human Behavior, 1st edn/1st printing edition (1939) ed. C.V. Mosby: St Louis.Google Scholar
Noyes, AP (1936). A Textbook of Psychiatry, 2nd edn. The Macmillan Company: New York.Google Scholar
Paton, S (2014). Psychiatry: A Text-Book for Students and Physicians. Forgotten Books: London, 2014 (originally published 1905).Google Scholar
Pope, HG Jr., Lipinski, JF Jr. (1978). Diagnosis in schizophrenia and manic-depressive illness: a reassessment of the specificity of ‘schizophrenic’ symptoms in the light of current research. Archives of General Psychiatry 35, 811828.Google Scholar
Sadler, WS (1936). Theory and Practice of Psychiatry. The C.V. Mosby Company: St Louis.CrossRefGoogle Scholar
Shorter, E (2009). The history of lithium therapy. Bipolar Disorders 11 (Suppl. 2), 49.CrossRefGoogle ScholarPubMed
Spitzer, RL, Endicott, J, Robins, E (1975). Research Diagnostic Criteria for a Selected Group of Functional Disorders, 2nd edn. New York Psychiatric Institute: New York.Google Scholar
Swazey, JP (1974). Chlorpromazine in Psychiatry: A Study of Therapeutic Innovation Cambridge. In stitute of Technology; The MIT Press: The Massachusetts.Google Scholar
Ulett, GA, Goodrich, DW (1956). A Synopsis of Contemporary Psychiatry. C.V. Mosby Company: St Louis.Google Scholar
White, WA (1913). Outlines of Psychiatry: Nervous and Mental Disease Monograph Series No. 1, 4th edn. The Journal of Nervous and Mental Disease Publishing Company: New York.Google Scholar
Yellowlees, H (1932). Clinical Lectures on Psychological Medicine. J. & A. Churchill: Baltimore, MD.Google Scholar