Bipolar Disorders: Mixed States, Rapid-Cycling, and Atypical Forms

389 Indexdepressive mixed states 51–2bipolar II and unipolar 52–3, 56distinguishing features 51depressive personality disorder (DPD) 114de Sauvages, Boissier de la Croix 159dexamethasone, effect on cortisol levels 336disability pensions 200–2, 201disinhibition syndrome 257, 258divalproex sodiumrapid-cycling disorder 79combined treatment with lithium 69, 80, 81,81, 82dopamine 312double depression 111dream-like states 217Dreyfus, G. L. 160drug abuse, comorbidity with mixed states 330–1dysphoric mania 47–8, 166, 325–6elderly sufferers of bipolarity 252atypical features 252age of onset and clinical course 253–4cognitive impairment 256neurologic comorbidity 255–6nosologic confusion 257vascular mania subtype criteria 258subtypes 257–8latent bipolar disorder 258primary bipolar disorder 257secondary mania (disinhibition syndrome) 258unipolar mania 258treatment of atypical conditions 259–60electroconvulsive therapy (ECT) 164agitated depression 179mixed depressive states 181endocrine psycho-syndrome 68Epidemiological Catchment Area (ECA) study253, 277Epidemiology of Mania (EPIMAN) study 48, 55, 326epidemiology of mood disorders 277–8adoption studies 286–7children and adolescentsage of onset 289family studies 287–8twin studies 288–9factors associated with familial transmission 283age of onset 284relationship to the proband 283–4sex of proband 284–5family studies 278–9future directions 298–300gene–environment interaction 297–8gene identification challenges 296genetic epidemiology 278genetic markersassociation studies 289–90linkage studies 291–2review of empirical evidence 290, 292, 293genotype and phenotype 296–7psychiatric disorder phenotypes 296review of empirical evidence 279–83proportion of first-degree relatives 281twin studies 285, 285–6heritability 285, 286epilepsy 65comorbidity with bipolar affective disorders 265Esquirol, E. 160euphoria 14excited–inhibited confusion psychosis 213extrapyramidal side-effects 354, 357Ey, Henri 215Falret, J. P. 160family studies 278–9factors associated with transmission of mooddisordersage of onset 284relationship to the proband 283–4sex of proband 284–5Fish, Frank 232Flemming, C. F. 160flight of ideas 169folie circulaire 24, 25gabapentin 74clinical response 75elderly patients 260Galenus of Pergamos 6gender differencesmixed states 15rapid-cycling disorder 27genetic heterogeneity 297genetics of bipolar disorderadoption studies 286–7children and adolescentsage of onset 289family studies 287–8twin studies 288–9factors associated with familial transmission 283age of onset 284