Affective Disorders: I. Recent Advances in Clinical Conceptualization

Part I of a two-part review of affective disorders focuses on recent epidemiologic and nosologic trends. Current clinical conceptualizations of the spectrum of affective disorders subsume many patients formerly considered schizophrenic, personality-disordered, neurotic, hypochondriacal, or demented. The inclusion of new subgroups within this spectrum has been validated by phenomenology, family history, pharmacologic response, course, and recently emerging laboratory markers. However, the authors believe that some of the research conducted with nonclinical populations with dysphoric symptoms has been unjustifiably extrapolated to clinical depressions; they provide guidelines for distinguishing nonspecific dysphoric reactions from affective disorder. Part II of the review, to be publisbed in the September H&CP, will cover advances in laboratory and pathogenetic approaches to affective disorders.