[Twosugars]

Originally Posted by Redway

A psychosis is just a mental illness in the strict sense of the word. I know the DSM likes to limit it more and more to hallucinations and delusions these days (which are even common in bipolar) but it’s been recognised as a type of insanity for centuries. It’s just that medication’s tampered the natural course of bipolar and there’s more emphasis on mild bipolar these days.

The lucid intervals have always been recognised. I don’t think anyone sees it as a chronic form of insanity but acute mania’s used as the stereotype of a mad person. That’s what bipolar’s like in its severe form.

And it should be said that having schizophrenia and bipolar at the same time is close to impssobile. The psychiatrists who love that hybrid schizoaffective label are usually the ones who are only familiar with the watered down version of bipolar and not manic depression in its serious form.

You don't agree with schizoaffective label? Kraepelin himself, whose book you cite, eventually questioned sharp division between schizophrenia and mood disorders and allowed that some cases may fall in between the two.
I dunno, my gut feeling is to treat disorders of affect separately from psychotic symptoms, like I said earlier.
Then again who really knows? As you say, DSM itself keeps on tinkering with the whole system. Probably we don't know yet how to classify things properly.