Mixed features in bipolar disorder
| العنوان: | Mixed features in bipolar disorder |
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| المؤلفون: | Eduard Vieta, Eva Solé, Marina Garriga, Marc Valentí |
| المصدر: | CNS Spectrums. 22:134-140 |
| بيانات النشر: | Cambridge University Press (CUP), 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | medicine.medical_specialty, Bipolar Disorder, Psychomotor agitation, Population, Comorbidity, Irritability, behavioral disciplines and activities, Suicide prevention, Suicidal Ideation, DSM-5, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, mental disorders, medicine, Humans, Bipolar disorder, Psychiatry, education, Depression (differential diagnoses), Depressive Disorder, Major, education.field_of_study, business.industry, Grandiosity, Prognosis, medicine.disease, 030227 psychiatry, Diagnostic and Statistical Manual of Mental Disorders, Psychiatry and Mental health, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery |
| الوصف: | Mixed affective states, defined as the coexistence of depressive and manic symptoms, are complex presentations of manic-depressive illness that represent a challenge for clinicians at the levels of diagnosis, classification, and pharmacological treatment. The evidence shows that patients with bipolar disorder who have manic/hypomanic or depressive episodes with mixed features tend to have a more severe form of bipolar disorder along with a worse course of illness and higher rates of comorbid conditions than those with non-mixed presentations. In the updated Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5), the definition of “mixed episode” has been removed, and subthreshold nonoverlapping symptoms of the opposite pole are captured using a “with mixed features” specifier applied to manic, hypomanic, and major depressive episodes. However, the list of symptoms proposed in the DSM–5 specifier has been widely criticized, because it includes typical manic symptoms (such as elevated mood and grandiosity) that are rare among patients with mixed depression, while excluding symptoms (such as irritability, psychomotor agitation, and distractibility) that are frequently reported in these patients. With the new classification, mixed depressive episodes are three times more common in bipolar II compared with unipolar depression, which partly contributes to the increased risk of suicide observed in bipolar depression compared to unipolar depression. Therefore, a specific diagnostic category would imply an increased diagnostic sensitivity, would help to foster early identification of symptoms and ensure specific treatment, as well as play a role in suicide prevention in this population. |
| تدمد: | 2165-6509 1092-8529 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ec6835fda8d45fcd7cc122e0025ca3b2 https://doi.org/10.1017/s1092852916000869 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....ec6835fda8d45fcd7cc122e0025ca3b2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21656509 10928529 |
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