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
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.