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Reviewing the diagnostic validity and utility of mixed depression (depressive mixed states)

Published online by Cambridge University Press:  16 April 2020

Franco Benazzi
Franco Benazzi*
Affiliation:
Hecker Psychiatry Research Center, University of California at San Diego, San Diego, CA, USA Collaborating Center, Forli, Italy Department of Psychiatry University of Szeged, Szeged, Hungary Department of Psychiatry, National Health Service, Forli, Italy
*
*Corresponding address: Via Pozzetto 17, 48015 Castiglione di Cervia RA, Italy. Tel.: +39 335 6191 852; fax: +39 054 330 069. E-mail address: francobenazzi@fbenazzi.it
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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.

Keywords

Bipolar I disorderBipolar II disorderMajor depressive disorderMixed depressionDepressive mixed statesDepressionAnxietyAgitation
Type
Review
Information
European Psychiatry , Volume 23 , Issue 1 , January 2008 , pp. 40 - 48
Copyright
Copyright © Elsevier Masson SAS 2008

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