Guidelines for the recognition and management of mixed depression. Stahl, S. M, Morrissette, D. A, Faedda, G., Fava, M., Goldberg, J. F, Keck, P. E, Lee, Y., Malhi, G., Marangoni, C., McElroy, S. L, Ostacher, M., Rosenblat, J. D, Solé, E., Suppes, T., Takeshima, M., Thase, M. E, Vieta, E., Young, A., Zimmerman, M., & McIntyre, R. S CNS Spectr., 22(2):203--219, April, 2017. 00000![Guidelines for the recognition and management of mixed depression [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex A significant minority of people presenting with a major depressive episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As this presentation may have important prognostic and treatment implications, the DSM-5 codified a new nosological entity, the "mixed features specifier," referring to individuals meeting threshold criteria for an MDE and subthreshold symptoms of (hypo)mania or to individuals with syndromal mania and subthreshold depressive symptoms. The mixed features specifier adds to a growing list of monikers that have been put forward to describe phenotypes characterized by the admixture of depressive and hypomanic symptoms (e.g., mixed depression, depression with mixed features, or depressive mixed states [DMX]). Current treatment guidelines, regulatory approvals, as well the current evidentiary base provide insufficient decision support to practitioners who provide care to individuals presenting with an MDE with mixed features. In addition, all existing psychotropic agents evaluated in mixed patients have largely been confined to patient populations meeting the DSM-IV definition of "mixed states" wherein the co-occurrence of threshold-level mania and threshold-level MDE was required. Toward the aim of assisting clinicians providing care to adults with MDE and mixed features, we have assembled a panel of experts on mood disorders to develop these guidelines on the recognition and treatment of mixed depression, based on the few studies that have focused specifically on DMX as well as decades of cumulated clinical experience.
@article{stahl_guidelines_2017,
title = {Guidelines for the recognition and management of mixed depression},
volume = {22},
issn = {1092-8529},
url = {http://dx.doi.org/10.1017/S1092852917000165},
doi = {10.1017/S1092852917000165},
abstract = {A significant minority of people presenting with a major depressive
episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As
this presentation may have important prognostic and treatment
implications, the DSM-5 codified a new nosological entity, the "mixed
features specifier," referring to individuals meeting threshold criteria
for an MDE and subthreshold symptoms of (hypo)mania or to individuals with
syndromal mania and subthreshold depressive symptoms. The mixed features
specifier adds to a growing list of monikers that have been put forward to
describe phenotypes characterized by the admixture of depressive and
hypomanic symptoms (e.g., mixed depression, depression with mixed
features, or depressive mixed states [DMX]). Current treatment guidelines,
regulatory approvals, as well the current evidentiary base provide
insufficient decision support to practitioners who provide care to
individuals presenting with an MDE with mixed features. In addition, all
existing psychotropic agents evaluated in mixed patients have largely been
confined to patient populations meeting the DSM-IV definition of "mixed
states" wherein the co-occurrence of threshold-level mania and
threshold-level MDE was required. Toward the aim of assisting clinicians
providing care to adults with MDE and mixed features, we have assembled a
panel of experts on mood disorders to develop these guidelines on the
recognition and treatment of mixed depression, based on the few studies
that have focused specifically on DMX as well as decades of cumulated
clinical experience.},
number = {2},
journal = {CNS Spectr.},
author = {Stahl, Stephen M and Morrissette, Debbi A and Faedda, Gianni and Fava, Maurizio and Goldberg, Joseph F and Keck, Paul E and Lee, Yena and Malhi, Gin and Marangoni, Ciro and McElroy, Susan L and Ostacher, Michael and Rosenblat, Joshua D and Solé, Eva and Suppes, Trisha and Takeshima, Minoru and Thase, Michael E and Vieta, Eduard and Young, Allan and Zimmerman, Mark and McIntyre, Roger S},
month = apr,
year = {2017},
note = {00000},
keywords = {Mixed, NEW, bipolar, depression, guidelines, unipolar},
pages = {203--219}
}
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