Franco Benazzi1. 1. Hecker Psychiatry Research Center, University of California at San Diego, San Diego, CA, USA. francobenazzi@fbenazzi.it
Abstract
OBJECTIVE: To review the diagnostic validity and utility of mixed depression, i.e. co-occurrence of depression and manic/hypomanic symptoms. METHODS: PubMed search of all English-language papers published between January 1966 and December 2006 using and cross-listing key words: bipolar disorder, mixed states, criteria, utility, validation, gender, temperament, depression-mixed states, mixed depression, depressive mixed state/s, dysphoric hypomania, mixed hypomania, mixed/dysphoric mania, agitated depression, anxiety disorders, neuroimaging, pathophysiology, and genetics. A manual review of paper reference lists was also conducted. RESULTS: By classic diagnostic validators, the diagnostic validity of categorically-defined mixed depression (i.e. at least 2-3 manic/hypomanic symptoms) is mainly supported by family history (the current strongest diagnostic validator). Its diagnostic utility is supported by treatment response (negative effects of antidepressants). A dimensionally-defined mixed depression is instead supported by a non-bi-modal distribution of its intradepression manic/hypomanic symptoms. DISCUSSION: Categorically-defined mixed depression may have some diagnostic validity (family history is the current strongest validator). Its diagnostic utility seems supported by treatment response.
OBJECTIVE: To review the diagnostic validity and utility of mixed depression, i.e. co-occurrence of depression and manic/hypomanic symptoms. METHODS: PubMed search of all English-language papers published between January 1966 and December 2006 using and cross-listing key words: bipolar disorder, mixed states, criteria, utility, validation, gender, temperament, depression-mixed states, mixed depression, depressive mixed state/s, dysphoric hypomania, mixed hypomania, mixed/dysphoric mania, agitated depression, anxiety disorders, neuroimaging, pathophysiology, and genetics. A manual review of paper reference lists was also conducted. RESULTS: By classic diagnostic validators, the diagnostic validity of categorically-defined mixed depression (i.e. at least 2-3 manic/hypomanic symptoms) is mainly supported by family history (the current strongest diagnostic validator). Its diagnostic utility is supported by treatment response (negative effects of antidepressants). A dimensionally-defined mixed depression is instead supported by a non-bi-modal distribution of its intradepression manic/hypomanic symptoms. DISCUSSION: Categorically-defined mixed depression may have some diagnostic validity (family history is the current strongest validator). Its diagnostic utility seems supported by treatment response.
Authors: Emma Robertson Blackmore; David R Rubinow; Thomas G O'Connor; Xiang Liu; Wan Tang; Nick Craddock; Ian Jones Journal: Bipolar Disord Date: 2013-05-07 Impact factor: 6.744
Authors: Islam Shahin; Caterina Del Mar Bonnin; Elsayed Saleh; Khaled Helmy; Usama M Youssef; Eduard Vieta Journal: Neuropsychiatr Dis Treat Date: 2020-09-28 Impact factor: 2.570
Authors: Mario Maj; Dan J Stein; Gordon Parker; Mark Zimmerman; Giovanni A Fava; Marc De Hert; Koen Demyttenaere; Roger S McIntyre; Thomas Widiger; Hans-Ulrich Wittchen Journal: World Psychiatry Date: 2020-10 Impact factor: 49.548
Authors: Ashwin Patkar; William Gilmer; Chi-un Pae; Paul A Vöhringer; Michael Ziffra; Edward Pirok; Molly Mulligan; Megan M Filkowski; Elizabeth A Whitham; Niki S Holtzman; Sairah B Thommi; Tanya Logvinenko; Antony Loebel; Prakash Masand; S Nassir Ghaemi Journal: PLoS One Date: 2012-04-24 Impact factor: 3.240