[Bipolar disorder and psychoanalytical concepts of depression and mania]

The categorical diagnostic model of bipolar disorders (DSM IV) has brought about increasing questioning, since its use gains troubles related not only to clinical experience, but to epidemiological studies as well. Regarding this, other models have emerged, such as the bipolar spectrum by Akiskal that covers the classic bipolar disorder on one side to unipolar disorder on the other, including soft bipolar disorders as well. The authors start from this notion of bipolar spectrum to set out the relationship between bipolar disease and psychoanalytical concepts of depression and mania. They develop Freud's basic theories and those of the British School that constitute a strong and coherent theoretical structure. Psychoanalysis proposes a unitary psychopathological model that manifests itself as depression or maniac reaction as secondary defense, to account for both the clinical expression and the psychodynamic comprehension of mood disorders.