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Bipolar missed states : the diagnosis and clinical salience of bipolar mixed states
journal contribution
posted on 2005-04-01, 00:00 authored by Michael BerkMichael Berk, Seetal DoddSeetal Dodd, G MahliObjective: To explore diagnostic and treatment issues concerning bipolar mixed states.
Method: Bipolar mixed states are described and concerns about diagnostic and treatment difficulties are summarized and discussed.
Result: Mixed states can present with equal admixtures of depressive or manic symptoms, or more commonly one component predominates. There is fair consensus, although little data, regarding the management of manic mixed states. However depressive mixed states are far more complex both in terms of recognition and management. People suffering from mixed states characteristically present with complaints of depression.
Conclusions: The boundaries between depressive mixed states and agitated depression are vague, yet carry substantial therapeutic implications. Bipolar mixed states are often difficult to treat, and tend to take much longer to settle than either pure mania or depression. Furthermore there is data that treatment with antidepressants can worsen the course of mixed states. Hence missed diagnoses can potentially have negative clinical implications. Therefore in this paper the clinical presentation, diagnosis and therapy of mixed states is reviewed with a view to improving management.
Method: Bipolar mixed states are described and concerns about diagnostic and treatment difficulties are summarized and discussed.
Result: Mixed states can present with equal admixtures of depressive or manic symptoms, or more commonly one component predominates. There is fair consensus, although little data, regarding the management of manic mixed states. However depressive mixed states are far more complex both in terms of recognition and management. People suffering from mixed states characteristically present with complaints of depression.
Conclusions: The boundaries between depressive mixed states and agitated depression are vague, yet carry substantial therapeutic implications. Bipolar mixed states are often difficult to treat, and tend to take much longer to settle than either pure mania or depression. Furthermore there is data that treatment with antidepressants can worsen the course of mixed states. Hence missed diagnoses can potentially have negative clinical implications. Therefore in this paper the clinical presentation, diagnosis and therapy of mixed states is reviewed with a view to improving management.
History
Journal
Australian and New Zealand journal of psychiatryVolume
39Issue
4Pagination
215 - 221Publisher
Informa HealthcareLocation
Abingdon, EnglandPublisher DOI
ISSN
0004-8674Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2005, Informa HealthcareUsage metrics
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