"Bipolarity" in the Setting of Dementia: Bipolar Type VI?

Hagop S. Akiskal, MD; Olavo Pinto, MD; Diogo R. Lara ,MD, PhD


January 06, 2005

In This Article

The Bipolar Spectrum

In a previous paper, bipolar prototypes I to IV have been described.[1] In a nutshell, this spectrum involves depression with varying degrees of excitatory signs and symptoms up to full-blown mania (prototype I), discrete hypomanic episodes (prototype II), hypomania associated with antidepressants and/or psychostimulants (prototype III), and hyperthymic temperament (prototype IV). In general, the "softer" the case, the later the onset of clinically observable mood disorder. Bipolar I is commonly manifested during teens and early adulthood, whereas prototype IV would present with depressive episodes around the fourth and fifth decades of life. There is also increasing evidence for a type V, characterized by recurrent depressions without discrete hypomania, but mixed hypomanic episodes (irritability/agitation/racing thoughts) during depression.[2]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.