The soft bipolar spectrum redefined: focus on the cyclothymic, anxious-sensitive, impulse-dyscontrol, and binge-eating connection in bipolar II and related conditions

Bipolar disorder has been divided into a clinical spectrum including bipolar I, bipolar II, bipolar III, and beyond. This article focuses on the soft bipolar spectrum representing bipolar II and its variants and accounting for most bipolar patients seen in clinical practice. The soft spectrum is typically characterized by temperamental instability of a cyclothymic nature, which overlaps significantly with the rejection sensitivity and mood reactivity observed in so-called "atypical" depressions, and the mood lability and irnpulsivity of those with borderline personality disorder. (n addition, the soft bipolar spectrum is characterized by high comorbidity with panic-agoraphobic, obsessive-compulsive, social phobic, body dysmorphic, bulimic, as well as alcohol and substance abuse disorders. The authors develop the hypothesis that the cvclothymic-anxioussensitive temperamental disposition might reprcscrtt the mediating underlying characteristic in the complex pattern of cumurbid mood, anxiety and impulse control disorders that Biopular II spectrum patients display clinically.