OBJECTIVE: To review the DSM-5 proposed criteria for mixed depression in light of robust and consistent historical and scientific evidence. METHOD: An extensive historical search, a systematic review of the papers used by DSM-5 as reference papers, and a PubMed search were performed. RESULTS: As Hippocrates, depressive mixed states have been described as conditions of intense psychic suffering, consisting of depressed mood, inner tension, restlessness, and aimless psychomotor agitation. In DSM-5, new criteria are proposed for a mixed features specifier, as part of depression either in major depressive disorder (MDD) or bipolar disorder. Those criteria require, as diagnostically specific, manic/hypomanic symptoms that are the least common kinds of symptoms that actually arise in depressive mixed states. The DSM-5 proposal is based, almost entirely, on a speculative wish to avoid 'overlapping' manic and depressive symptoms. Mixed states are, in fact, nothing but overlapping manic and depressive symptoms. CONCLUSION: In this article, we review the psychopathology and research on mixed depressive states, and try to demonstrate that the DSM-5 proposal has weak scientific basis and does not identify a large number of mixed depressive states. This may be harmful because of the different treatment required by these conditions.
OBJECTIVE: To review the DSM-5 proposed criteria for mixed depression in light of robust and consistent historical and scientific evidence. METHOD: An extensive historical search, a systematic review of the papers used by DSM-5 as reference papers, and a PubMed search were performed. RESULTS: As Hippocrates, depressive mixed states have been described as conditions of intense psychic suffering, consisting of depressed mood, inner tension, restlessness, and aimless psychomotor agitation. In DSM-5, new criteria are proposed for a mixed features specifier, as part of depression either in major depressive disorder (MDD) or bipolar disorder. Those criteria require, as diagnostically specific, manic/hypomanic symptoms that are the least common kinds of symptoms that actually arise in depressive mixed states. The DSM-5 proposal is based, almost entirely, on a speculative wish to avoid 'overlapping' manic and depressive symptoms. Mixed states are, in fact, nothing but overlapping manic and depressive symptoms. CONCLUSION: In this article, we review the psychopathology and research on mixed depressive states, and try to demonstrate that the DSM-5 proposal has weak scientific basis and does not identify a large number of mixed depressive states. This may be harmful because of the different treatment required by these conditions.
Authors: Manish K Jha; Ashley L Malchow; Bruce D Grannemann; A John Rush; Madhukar H Trivedi Journal: Neuropsychopharmacology Date: 2018-08-15 Impact factor: 7.853
Authors: Michael B First; Wolfgang Gaebel; Mario Maj; Dan J Stein; Cary S Kogan; John B Saunders; Vladimir B Poznyak; Oye Gureje; Roberto Lewis-Fernández; Andreas Maercker; Chris R Brewin; Marylene Cloitre; Angelica Claudino; Kathleen M Pike; Gillian Baird; David Skuse; Richard B Krueger; Peer Briken; Jeffrey D Burke; John E Lochman; Spencer C Evans; Douglas W Woods; Geoffrey M Reed Journal: World Psychiatry Date: 2021-02 Impact factor: 49.548
Authors: S Nassir Ghaemi; Jules Angst; Paul A Vohringer; Eric A Youngstrom; James Phelps; Philip B Mitchell; Roger S McIntyre; Michael Bauer; Eduard Vieta; Samuel Gershon Journal: Int J Bipolar Disord Date: 2022-10-13
Authors: Andrea Fagiolini; Anna Coluccia; Giuseppe Maina; Rocco N Forgione; Arianna Goracci; Alessandro Cuomo; Allan H Young Journal: CNS Drugs Date: 2015-09 Impact factor: 5.749