Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-18T05:00:39.319Z Has data issue: false hasContentIssue false

Mixed Episodes with Psychotic Features

Published online by Cambridge University Press:  07 November 2014

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
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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):3742.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):17531755.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;117:216224.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;19:8590.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;91:133138.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;23:370376.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;160:741748.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;107:145154.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;67:12461252.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):476488.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):13511360.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;19:520532.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):500505.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;20:195203.CrossRefGoogle Scholar