G. PERUGI, G. TUSIN, A. NASSIMBEN, I. MAREMMA, H.S. AKIS - Vol. 9, September 2003, Issue 3
Bipolar Disorder (DB) is currently subdivided in a clinical spectrum with different subtypes, based on the presence of hypomanic episodes, family history for bipolar disorder, pharmachological hypomania, cyclothymic or hyperthymic temperament. In the present article we discuss the mood disorders characterized by mild elated symptomatology, representing the bipolar II spectrum and its clinical variants. These clinical pictures affect most patients with DB observed, today, in routine clinical practice. "Bipolar II spectrum" is characterized by a high rate of comorbidity with panic-agoraphobic, obsessive-compulsive, social anxiety, body-dysmorphic, impulse control, eating disorders and alcohol and drug abuse. The co-existence with personality disorders of the anxious and dramatic cluster such as Avoidant, Dependent, Borderline, Histrionic and Narcissistic, is also common. The authors formulate and develop the hypothesis that a cyclothymic-anxious diathesis might represent the common denominator underlying the complex mixture of mood, anxiety and impulse-control disorders, which patients belonging to the bipolar II spectrum display during their entire lifetime.