Bipolar missed states : the diagnosis and clinical salience of bipolar mixed states Berk, Michael, Dodd, Seetal and Mahli, Gin S. 2005, Bipolar missed states : the diagnosis and clinical salience of bipolar mixed states, Australian and New Zealand journal of psychiatry, vol. 39, no. 4, pp. 215-221, doi: 10.1080/j.1440-1614.2004.01557.x. Attached Files Name Description MIMEType Size Downloads Title Bipolar missed states : the diagnosis and clinical salience of bipolar mixed states Author(s) Berk, Michael orcid.org/0000-0002-5554-6946 Dodd, Seetal orcid.org/0000-0002-7918-4636 Mahli, Gin S. Journal name Australian and New Zealand journal of psychiatry Volume number 39 Issue number 4 Start page 215 End page 221 Publisher Informa Healthcare Place of publication Abingdon, England Publication date 2005-04 ISSN 0004-8674 Keyword(s) bipolar depression dysphoric mania diagnosis bipolar disorder Summary Objective: 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. Language eng DOI 10.1080/j.1440-1614.2004.01557.x Field of Research 111714 Mental Health Socio Economic Objective 920410 Mental Health HERDC Research category C1.1 Refereed article in a scholarly journal Copyright notice ©2005, Informa Healthcare Persistent URL http://hdl.handle.net/10536/DRO/DU:30035538 Document type: Journal Article Collections: Faculty of Health School of Medicine Related Links Link Description Connect to published version (restricted access) Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Wed, 22 Jun 2011, 12:33:29 EST Fri, 07 Oct 2011, 09:22:29 EST Fri, 07 Oct 2011, 09:23:55 EST Tue, 11 Oct 2011, 13:02:12 EST Filtered Full Citation counts:   Cited 57 times in TR Web of Science Cited 61 times in Scopus Search Google Scholar Access Statistics: 764 Abstract Views, 0 File Downloads  -  Detailed Statistics Created: Wed, 22 Jun 2011, 12:33:29 EST