Mood Disorders

All changes have both good and bad consequences. However, on occasion, some of the ramifications can also be ‘ugly’. In a similar vein to Sergio Leone’s classic , ICD-11 has finally, after 30 years, revised its description of mood disorders. The good things are that they have dispensed with the term ‘affective’, introduced the concept of clusters of mood symptoms, and combined depression and bipolar disorder into a unified spectrum of mood disorders. The bad things are a missed opportunity to fully embrace mixed states and extend some of the innovations that have been applied to depression to its counterparts namely, mania and mixed mood states. However, it is the ugly that is most disturbing, as they have blindly embraced the erroneous concept of subtyping bipolar disorder – a venture that has been a categorical disaster. Queue Ennio Morricone.