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.

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Title Bipolar missed states : the diagnosis and clinical salience of bipolar mixed states
Author(s) Berk, MichaelORCID iD for Berk, Michael
Dodd, SeetalORCID iD for Dodd, Seetal
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
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
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Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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