ABSTRACT
This chapter looks more closely at our current psychiatric diagnostic systems, the ICD and, in particular, the DSM, which is the most widely used diagnostic compendium in the US. Mood disorders in the DSM are divided into bipolar disorders and depressive disorders a la conceptualization of Leonhard. People with bipolar disorders cycle between LOW ENERGY depressive states and HIGH ENERGY hypomanic/manic states. While there is only one mood phase associated with the low energy depressive state (the negative mood of depression), there are two mood phases associated with the high energy hypomanic/manic state (the positive mood of euphoria and the negative mood of dysphoria). It is crucial to distinguish between the negative mood of depression and the negative mood of dysphoria, both for diagnostic and treatment purposes. Bipolar disorders in the DSM are categorized along a spectrum of symptom severity. Recognizing the numerous iterations of mood disorders not described in the DSM, Hagop Akiskal and his colleagues elaborated an array of related mood syndromes known as the “soft bipolar spectrum.” A newcomer to the group of depressive disorders in the latest edition of the DSM is “disruptive mood dysregulation disorder” (DMDD), which does not require depression as a diagnostic criterion. We will discuss this curious addition further.
