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[Affective disorders: Evolution of nosographic models].

A Kaladjian1, J-M Azorin, M Adida

  • 1Service de Psychiatrie des Adultes, CHU Robert Debré, Avenue du Général Koenig, 51092 Reims cedex, France. akaladjian@chu-reims.fr

L'Encephale
|January 18, 2011
PubMed
Summary

Affective disorders evolved from general mental illness categories to distinct diagnoses like manic-depressive insanity. Future psychiatric nosography may advance through clinical epidemiology and pathophysiology studies.

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Area of Science:

  • Psychiatry and Mental Health
  • Clinical Psychology
  • Medical History

Background:

  • Affective disorders have evolved historically within psychiatric nosography.
  • Kraepelin's concept of manic-depressive insanity marked a significant step in classifying these disorders.
  • Current classifications, like the Diagnostic and Statistical Manual of Mental Disorders (DSM), largely use a categorical approach.

Purpose of the Study:

  • To trace the historical nosographic evolution of affective disorders.
  • To examine the current categorical approach in psychiatric nosography, particularly within the DSM.
  • To explore potential future directions for nosographic advances in affective disorders.

Main Methods:

  • Historical analysis of psychiatric nosographies.
  • Review of diagnostic criteria and classification systems, including the DSM.
  • Discussion of emerging research methodologies in clinical epidemiology and pathophysiology.

Main Results:

  • Affective disorders were progressively distinguished as separate entities.
  • The division into bipolar disorder and recurrent depression remains current, largely influenced by the DSM.
  • The DSM's categorical approach shapes contemporary nosographic models, with potential for dimensional components in future revisions.

Conclusions:

  • Future nosographic advancements for affective disorders are anticipated from clinical epidemiology studies identifying subtypes.
  • Etiological research focusing on pathophysiology offers a path toward objective, knowledge-based nosographic models.
  • Integrating dimensional approaches and objective biological data may refine future classifications.