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Frequency of manic symptoms during a depressive episode and unipolar ‘depressive mixed state’ as bipolar spectrum
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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“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]
In the citing paper
“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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Metadata
- 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
- 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
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology (medical) › 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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