A history of bipolar disorder: From Areteo of Cappadocia to DSM-IV and bipolar spectrum. [Storia del disturbo bipolare: Da Areteo di Cappadocia al DSM-IV e bipolar spectrum]

The history of bipolar disorder started off in ancient Greece. The first to describe melancholia and mania as two aspects of the same disease was Areteo from Cappadocia in the I century B.C. The concept of modern bipolar disorder has its birth in France with works by Farlet about folie circulaire (1851, 1854) and Baillarger (1854) about folie à double forme. Later on Emil Kraepelin (1896) they gathered together all distressed disorders in “manic-depressive insanity”, distinguishing it from dementia praecox. The Kraepelin unit concept, excluding some exceptions, has been widely agreed worldwide. Definitive distinction between unipolar and bipolar affective disorders is owed to the works of Leonhard (1957), Angst (1966) and Perris (1966) in Europe and of Winokur and Clayton (1967) in the US and it is still kept in DSM-IV nosology. Moreover, borders of bipolar disorder concept have been widened with the distinction of schizoaffective disorders in unipolar and bipolar forms, through the re-birth of Kraepelinian concepts of mixed states and temperament and the description of “bipolar spectrum”. Through the analysis of classical and modern literature we outlined the history of bipolar disorder, tracing the main stages of its evolution to categorical nosology of DSM-IV and to the efforts to pass it.