A pragmatic approach to the diagnosis and treatment of mixed features in adults with mood disorders

CNS Spectrums

Volumn 21, Issue S1, 2016, Pages 28-32

  McIntyre, Roger S ^a,b   Lee, Yena ^a,b   Mansur, Rodrigo B ^a  

^a UNIVERSITY OF TORONTO   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

Author keywords

bipolar spectrum; depression spectrum; Key words Bipolar disorder; major depressive disorder; mixed features; mixed states

Indexed keywords

ANTIDEPRESSANT AGENT; LURASIDONE; MOOD STABILIZER; NEUROLEPTIC AGENT; ZIPRASIDONE; LITHIUM DERIVATIVE; PIPERAZINE DERIVATIVE; THIAZOLE DERIVATIVE; TRANQUILIZER;

BIPOLAR DISORDER; CLINICAL ASSESSMENT; CLINICAL FEATURE; DISEASE CLASSIFICATION; DISEASE SEVERITY; DRUG EFFICACY; DRUG SAFETY; DSM-5; FUNCTIONAL DISEASE; HUMAN; MAJOR DEPRESSION; MIXED FEATURES SPECIFIER; MONTGOMERY ASBERG DEPRESSION RATING SCALE; MOOD DISORDER; PHENOMENOLOGY; PRIORITY JOURNAL; REVIEW; SEMI STRUCTURED INTERVIEW; SYMPTOMATOLOGY; TRANSCRANIAL MAGNETIC STIMULATION; ADULT; COGNITIVE THERAPY; DEPRESSIVE DISORDER, MAJOR; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; MOOD DISORDERS; PSYCHOLOGY;

ADULT; ANTIMANIC AGENTS; ANTIPSYCHOTIC AGENTS; BIPOLAR DISORDER; COGNITIVE THERAPY; DEPRESSIVE DISORDER, MAJOR; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; HUMANS; LITHIUM COMPOUNDS; MOOD DISORDERS; PIPERAZINES; THIAZOLES;

EID: 85008440503     PISSN: 10928529     EISSN: None     Source Type: Journal    
DOI: 10.1017/S109285291600078X     Document Type: Review

References (25)

1. Targum SD, Suppes T, Pendergrass JC, et al. Major depressive disorder with subthreshold hypomania (mixed features): clinical characteristics of patients entered in a multiregional, placebocontrolled study. Prog Neuropsychopharmacol Biol Psychiatry. 2016; 68: 9-14.
2. Freedman R, Lewis DA, Michels R, et al. The initial field trials of DSM-5: new blooms and old thorns. Am J Psychiatry. 2013; 170(1): 1-5.
3. McIntyre RS. Practical approaches in the management of bipolar depression: overcoming challenges and avoiding pitfalls. Evidencebased treatment of bipolar disorder, bipolar depression, and mixed features. J Fam Pract. 2015; 64(6 Suppl): S16-S23.
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
5. Modell S, Huber J, Holsboer F, Lauer CJ. The Munich Vulnerability Study on Affective Disorders: risk factors for unipolarity versus bipolarity. J Affect Disord. 2003; 74(2): 173-184.
6. Goldberg JF, Perlis RH, Bowden CL, et al. Manic symptoms during depressive episodes in 1,380 patients with bipolar disorder: findings from the STEP-BD. Am J Psychiatry. 2009; 166(2): 173-181.
7. Perugi G, Angst J, Azorin JM, et al. Mixed features in patients with a major depressive episode: the BRIDGE-II-MIX study. J Clin Psychiatry. 2015; 76(3): e351-e358.
8. Suppes T, Mintz J, McElroy SL, et al. Mixed hypomania in 908 patients with bipolar disorder evaluated prospectively in the Stanley Foundation Bipolar Treatment Network: a sex-specific phenomenon. Arch Gen Psychiatry. 2005; 62(10): 1089-1096.
9. Judd LL, Paulus MP, Wells KB, Rapaport MH. Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am J Psychiatry. 1996; 153 (11): 1411-1417.
10. Florida Best Practice Psychotherapeutic Medication Guidelines for Adults. Florida Medicaid Drug Therapy Management Program for Behavioral Health; 2015. http://www.medicaidmentalhealth.org/-assets/file/Guidelines/Web-2015-Psychotherapeutic%20Medication%20Guidelines%20for%20Adults-Final-Approved1.pdf.
11. Salvatore P, Baldessarini RJ, Centorrino F, et al. Weygandt's On the Mixed States of Manic-Depressive Insanity: a translation and commentary on its significance in the evolution of the concept of bipolar disorder. Harv Rev Psychiatry. 2002; 10(5): 255-275.
12. Swann AC, Lafer B, Perugi G, et al. Bipolar mixed states: an International Society for Bipolar Disorders task force report of symptom structure, course of illness, and diagnosis. Am J Psychiatry. 2013; 170(1): 31-42.
13. Akiskal HS, Benazzi F, Perugi G, Rihmer Z. Agitated "unipolar" depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy. J Affect Disord. 2005; 85(3): 245-258.
14. Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler W. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord. 2003; 73(1-2): 133-146.
15. Malhi GS, Lampe L, Coulston CM, et al. Mixed state discrimination: a DSM problem that wont go away? J Affect Disord. 2014; 158: 8-10.
16. McIntyre RS, Soczynska JK, Cha DS, et al. The prevalence and illness characteristics of DSM-5-defined "mixed feature specifier" in adults with major depressive disorder and bipolar disorder: Results from the International Mood Disorders Collaborative Project. J Affect Disord. 2014; 172C: 259-264.
17. Miller S, Suppes T, Mintz J, et al. Mixed depression in bipolar disorder: prevalence rate and clinical correlates during naturalistic follow-up in the Stanley Bipolar Network. Am J Psychiatry. 2016; 173(10): 1015-1023.
18. Zimmerman M, Chelminski I, Young D, Dalrymple K, Martinez JH. A clinically useful self-report measure of the DSM-5 mixed features specifier of major depressive disorder. J Affect Disord. 2014; 168: 357-362.
19. Rosenblat JD, McIntyre RS. Treatment recommendations for DSM-5-defined mixed features. CNS Spectr. In press. DOI: 10.1017/S1092852916000432.
20. Maj M, Pirozzi R, Magliano L, Fiorillo A, Bartoli L. Agitated "unipolar" major depression: prevalence, phenomenology, and outcome. J Clin Psychiatry. 2006; 67(5): 712-719.
21. Patkar A, Gilmer W, Pae CU, et al. A 6 week randomized doubleblind placebo-controlled trial of ziprasidone for the acute depressive mixed state. PLoS One. 2012; 7(4): e34757.
22. Suppes T, Silva R, Cucchiaro J, et al. Lurasidone for the treatment of major depressive disorder with mixed features: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2016; 173(4): 400-407.
23. McIntyre RS, Cha DS, Soczynska JK, et al. Cognitive deficits and functional outcomes in major depressive disorder: determinants, substrates, and treatment interventions. Depress Anxiety. 2013; 30(6): 515-527.
24. McIntyre RS, Alsuwaidan M, Soczynska JK, et al. The effect of lisdexamfetamine dimesylate on body weight, metabolic parameters, and attention deficit hyperactivity disorder symptomatology in adults with bipolar I/II disorder. Hum Psychopharmacol. 2013; 28 (5): 421-427.
25. Fiedorowicz JG, Endicott J, Solomon DA, et al. Course of illness following prospectively observed mania or hypomania in individuals presenting with unipolar depression. Bipolar Disord. 2012; 14(16): 664-671.