DSM+II+1968

36 MENTAL DISORDERS
related directly to a precipitating life experience and therefore is distinguishable
from Psychotic depressive reaction and Depressive neurosis.
(This category is not equivalent to the DSM-I heading "Affective reactions,"
which included "Psychotic depressive reaction.")
296.0 Involutional melancholia
This is a disorder occurring in the involutional period and characterized
by worry, anxiety, agitation, and severe insomnia. Feelings of
guilt and somatic preoccupations are frequently present and may be
of delusional proportions. This disorder is distinguishable from Manicdepressive
illness (q.v.) by the absence of previous episodes; it is
distinguished from Schizophrenia (q.v.) in that impaired reality
testing is due to a disorder of mood; and it is distinguished from
Psychotic depressive reaction (q.v.) in that the depression is not
due to some life experience. Opinion is divided as to whether this
psychosis can be distinguished from the other affective disorders. It
is, therefore, recommended that involutional patients not be given this
diagnosis unless all other affective disorders have been ruled out. (In
DSM-I this disorder was included under "Disorders due to disturbances
of metabolism, growth, nutrition or endocrine function.")
Manic-depressive illnesses (Manic-depressive psychoses)
These disorders are marked by severe mood swings and a tendency
to remission and recurrence. Patients may be given this diagnosis in
the absence of a previous history of affective psychosis if there is no
obvious precipitating event. This disorder is divided into three
major subtypes: manic type, depressed type, and circular type.
296.1 Manic-depressive illness, manic type ((Manic-depressive
psychosis, manic type))
This disorder consists exclusively of manic episodes. These episodes
are characterized by excessive elation, irritability, talkativeness, flight
of ideas, and accelerated speech and motor activity. Brief periods of
depression sometimes occur, but they are never true depressive episodes.
296.2 Manic-depressive illness, depressed type ((Manic-depressive
psychosis, depressed type))
This disorder consists exclusively of depressive episodes. These
episodes are characterized by severely depressed mood and by mental
and motor retardation progressing occasionally to stupor. Uneasiness,
apprehension, perplexity and agitation may also be present.