Koukopoulos Athanasios, Sani Gabriele, Koukopoulos Alexia E, Albert Matthew J, Girardi Paolo, Tatarelli Roberto
Centro Lucio Bini, Rome, Italy.
J Affect Disord. 2006 Dec;96(3):165-75. doi: 10.1016/j.jad.2006.08.031. Epub 2006 Sep 25.
In this special issue dedicated to Falret and the French contributions to the concept of cyclicity in manic depressive illness, we begin with a historical overview of the development of the concept of cyclicity and its fundamental significance in manic-depressive illness and we underscore how the concept fell into neglect only to reemerge in recent years. We then look at the intimate relationship between mania and depression. The hypothesis of the primacy of mania is discussed. The thesis is presented, supported by the examination of 100 consecutive index manias, that in most cases mania is triggered by external factors acting upon hyperthymic patients, determining an exogenous cyclicity. On the other hand, in BPII patients the temperamental mood instability (cyclothymia) is an inherent and decisive factor in determining the cyclic autonomous course of the disorder. Finally, a new distinction of Bipolar Disorders, based on premorbid temperament and course of the illness, is considered.
在这一专门探讨法勒（Falret）以及法国对躁郁症周期性概念贡献的特刊中，我们首先对周期性概念的发展及其在躁郁症中的根本意义进行历史概述，并强调该概念是如何一度被忽视，直到近年来才重新出现。接着，我们审视躁狂与抑郁之间的密切关系。讨论了躁狂原发性的假说。通过对100例连续的首发躁狂病例进行研究，提出论点：在大多数情况下，躁狂是由作用于情感高涨患者的外部因素引发的，从而决定了外源性周期性。另一方面，在双相II型障碍患者中，气质性情绪不稳定（环性心境障碍）是决定该疾病周期性自主病程的内在决定性因素。最后，考虑基于病前气质和病程对双相情感障碍进行新的分类。
