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Cited by 170Bipolar Disorder and TreatmentTreatment of Major DepressionPersonality Disorders and Psychopathology

Frequency of manic symptoms during a depressive episode and unipolar ‘depressive mixed state’ as bipolar spectrum

Sato, T., Bottlender, R., Schröter, A., Möller, H.‐J.·2003·Acta Psychiatrica Scandinavica
DOI 10.1034/j.1600-0447.2003.00051.x
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Abstract

Objective: To report the frequency of intra‐episode manic symptoms in depressive episodes, and to evaluate unipolar depressive mixed state (DMS) as bipolar spectrum. Method: A total of 958 (863 unipolar, 25 bipolar II, and 70 bipolar I) depressive in‐patients were assessed in terms of manic symptoms at admission, and several clinical variables using standardized methods. Results: The frequency of manic symptoms (flight of idea, logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility) was significantly higher in bipolar depressives than in unipolar depressives. Unipolar depressives with DMS – defined as having two or more manic symptoms – had more similarities to bipolar depressives than to other unipolar depressives in clinical variables such as onset age, family history of bipolar disorder, and possibly suicidality. Conclusion: Depressive mixed state is frequent, particular in bipolar depressives. Unipolar depressives with DMS may be better classified into bipolar spectrum.

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  • The fact that several people with recurrent depression experience some episodes which are melancholic and some others which are not seems to argue in favour of melancholia being the most severe manifestation of depression rather than a distinct disease entity.

    “However, the fact that several people with recurrent depression experience some episodes which are melancholic and some others which are not 58 seems to argue in favour of the latter option.”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [58]

  • The DSM/ICD approach of considering melancholic and psychotic features as 'specifiers' or 'qualifiers' to the diagnosis of depression, rather than assuming that melancholia and psychotic depression are distinct diagnostic entities, is supported by the evidence that, in many people with recurrent depression, some episodes are either psychotic or melancholic and some others are not.

    “The DSM/ICD approach, considering melancholic and psychotic features as 'specifiers' or 'qualifiers' to the diagnosis of depression, rather than assuming that melancholia and psychotic depression are distinct diagnostic entities, is also supported by the evidence that, in many people with recurrent depression, some episodes are either psychotic or melancholic and some others are not. 58,86”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [58]

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Authors
Sato, T., Bottlender, R., Schröter, A., & Möller, H. ‐.
Affiliations
Ludwig-Maximilians-Universität München (DE)
Corresponding author
Sato, T.
ORCID
Möller, H.‐J.
Venue
Acta Psychiatrica Scandinavica
Publisher
Wiley
Published
2003-03-27
Volume
107
Issue
4
Pages
268-274
ISSN
  • 0001-690X (ISSN-L)
  • 1600-0447
DOI
10.1034/j.1600-0447.2003.00051.x
OpenAlex
W2114010171
Cited by
170
References
35
Citations by year
2026: 1 · 2025: 3 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 7 · 2018: 3 · 2017: 3 · 2016: 5 · 2015: 18 · 2014: 8 · 2013: 8 · 2012: 6
FWCI
13.51
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Acta Psychiatrica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
depressive mixed state, manic symptoms, bipolar spectrum, bipolar disorder, major depressive disorder, depressive episodes, bipolar II disorder, bipolar I disorder, irritability, suicidality, family history of bipolar disorder, age of onset
MeSH terms
Adult, Affect, Bipolar Disorder, Depression, Female, Humans, Male, Middle Aged, Periodicity, Severity of Illness Index, Disease Progression

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