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Mixed Episodes with Psychotic Features

Published online by Cambridge University Press:  07 November 2014

James C.-Y. Chou
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Extract

Mixed episode is one of the more difficult-to-treat conditions in bipolar disorder. The presence of mixed features (symptoms of both depression and mania in a single acute episode) is associated with both poorer acute treatment response and poorer longitudinal outcomes, including shorter subsequent inter-episode periods and greater suicidality. Mixed features are indicative of an overall greater severity of both acute and chronic illness (Slide 1).

Type
Expert Panel Supplement
Information
CNS Spectrums , Volume 14 , Issue S11: Clinical Decisions for Acute and Mixed Manic Episodes of Bipolar Disorder: A Case-based Approach , November 2009 , pp. 6 - 8
Copyright
Copyright © Cambridge University Press 2009

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References

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Association; 1994.Google Scholar
2.Swann, AC, Bowden, CL, Morris, D et al. , Depression during mania. Treatment response to lithium or divalproex. Arch Gen Psychiatry. 1997;54(1):37–42.CrossRefGoogle ScholarPubMed
3.Goldberg, JF, Carno, JL, Leon, AC et al. , Association of recurrent suicidal ideation with nonremission from acute mixed mania. Am J Psychiatry. 1998;155(12):1753–1755.CrossRefGoogle ScholarPubMed
4.Azorin, JM, Aubrun, E, Bertsch, J, Reed, C, Gerard, S, Lukasiewicz, M. Mixed states vs. pure mania in the French sample of the EMBLEM study: results at baseline and 24 months–European mania in bipolar longitudinal evaluation of medication. BMC Psychiatry. 2009;9:33 doi:10.1186/1471–244X/9/33.CrossRefGoogle ScholarPubMed
5.Kessling, LV. The prevalence of mixed episodes during the course of illness in bipolar disorder. Acta Psychiatr Scand. 2008;117:216–224.CrossRefGoogle Scholar
6.Benazzi, F, Koukopoulos, A, Akiskal, HS. Toward a validation of a new definition of agitated depression as a bipolar mixed state (mixed depression). Eur Psychiatry. 2004;19:85–90.CrossRefGoogle Scholar
7.Balazs, J, Benazzi, F, Rihmer, Z, Rihmer, A, Akiskal, KK, Akiskal, HS. The close link between suicide attempts and mixed (bipolar) depression: Implications for suicide prevention. J Aff Disord. 2006;91:133–138.CrossRefGoogle ScholarPubMed
8.Baldessarini, RJ, Hennen, J, Wilson, M et al. , Olanzapine vs. placebo in acute mania: treatment responses in subgroups. J Clin Psychopharmacol. 2003;23:370–376.CrossRefGoogle Scholar
9.Keck, PE, Versiani, M, Potkin, S, West, SA, Giller, E, Ice, K. Ziprasidone in mania study group. Ziprasidone in the treatment of acute bipolar mania: a three-week, placebo-controlled, double blind, randomized trial. Am J Psychiatry. 2003;160:741–748.CrossRefGoogle Scholar
10.Suppes, T, Eudicone, J, McQuate, R, Pikalov, A, Carlson, B. Efficacy and safety of aripiprazole in subpopulations with acute mania or mixed episodes of bipolar I disorder. J Affect Disord. 2008;107:145–154.CrossRefGoogle ScholarPubMed
11.Houston, JP, Ahl, J, Meyers, AL, Kaiser, CJ, Tohen, M, Baldessarini, RJ. Reduced suicidal ideation in bipolar I disorder mixed-episode patients in a placebo-controlled trial of olanzapine combined with lithium or divalproex. J Clin Psychiatry. 2006;67:1246–1252.CrossRefGoogle ScholarPubMed
12.Suppess, T, Vieta, E, Liu, S et al. , Maintenance treatment for patients with bipolar I disorder: results from a north american study of quetiapine in combination with lithium or divalproex (trial 127). Am J Psychiatry. 2009;166(4):476–488.CrossRefGoogle Scholar
13.Calabrese, JR, Keck, PE Jr, Macfadden, W et al. , A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. Am J Psychiatry. 2005;162(7):1351–1360.CrossRefGoogle ScholarPubMed
14.Goodwin, G, Fleischhacker, W, Arango, C et al. , Advantages and disadvantages of combination treatment with antipsychotics. ECNP Consensus Meeting, March, 2008. Eur Neuropsychopharmacol. 2009;19:520–532.CrossRefGoogle ScholarPubMed
15.Chou, JCY, Czobor, P, Charles, O et al. , Acute Mania: haloperidol dose and augmentation with lithium or lorazepam. J Clin Psychopharmacol. 1999;19(6):500–505.CrossRefGoogle ScholarPubMed
16.Muller-Oerlinghausen, B, Retzow, A, Henn, FA, Giedke, H, Walden, J (European Valproate Mania Study Group): Valproate as an adjunct to neuroleptic medication for the treatment of acute episodes of mania: a prospective, randomized, double-blind, placebo-controlled, multicenter study. J Clin Psychopharmacol. 2000;20:195–203.CrossRefGoogle Scholar