A psychometric study of unipolar and bipolar affective disorders

Abstract

This study first looks into the development of psychiatric and psychological concepts of affective illness. After an overview of the historical background, the debates about classification in affective illness are examined and it is concluded that a classification in terms of bipolar (manic-depressive) and unipolar (recurrent depressive) types seems valid, specially from the genetic viewpoint, and needs further definition.The psychological literature in the field of affective disorders is surveyed and found not to be extensive particularly with regard to mania, and to have produced, on the whole, contradictory results because of the uncertainty of nosological systems.This study alias to describe and define homogeneous groups of affective disordered patients in terms of bipolar and unipolar illness, by objective psychological methods.Patients from both poles of bipolar affeotive illness are studied, i.e. manic and depressed manic depressives and also depressed unipolar patients. In addition, patients having recovered from each of these 3 illnesses are also studied. Thus, six groups are examined in a oros3-sactional design, under strict clinical criteria. There are 18 subjects in each group, except for the depressed bipolars of whoa there are 17.The parameters on which the Groups are compared are; signs and symptoms of illness (individual symptoms, a-priori scales of different psychiatric syndromes, a scale of personal disturbance), 4 measures of personality traits and attitudes (anxiety, extre¬ version, intropunitiveness, extrapunitiveness), 4 measures of thought pro coos (intensity and consistency of thought, number of normal and abnormal responses on an object-sorting test), 3 measures of psycho-motor speed (speed of maze tracing, speed of maze tracing with an •internal* distraction, speed of maze treeing with an 'external' distraction), and 3 measures of mental speed (speed of problem solving at preferred speed of work, speed of problem solving with stress, gain in speed of problem solving with stress).The particular alas are to find out: how mania differs from bipolar and unipolar depression? how the two types of depression differ, if at all; how the recovered groups differ, that is, are there 'premorbid' differences in people who develop bipolar or unipolar affective illnesses; and finally, what is the effect of illness in each group.The general hypotheses tea ted are:1. Manias will differ from bipolar and unipolar depressives on several parameters: signs and symptoms of illness, personality traits and attitudes and cognitive factors.2. Bipolar depressives will differ from unipolar depressives, but the differences will not be as pronounced as those between manics on the one hand and the two depressive groups on the other.3. Patients having recovered from a bipolar affective illness will differ from patients having recovered from a unipolar affective illness, mainly in personality characteristics.4. The effects of illness will be marked in e&oh illness group, affecting both personality and cognitive factors, and will be illness specific, that is, each illness will bring about different changes rather than a general change common to all groups.These hypotheses are all borne out in the main findings which are reached at statistically.The general conclusion is that bipolar and unipolar affective disorders differ not only in that one consists only of recurrent depression and the other of recurrent depression and mania, but also the depressive illnesses of each disorder are different on several important parameters, and people who develop one or the other disorder differ in 'premorbid' personality traits

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