The Complexity of “Mixed” Depression: A Common Clinical Presentation

[摘要] Most clinicians use the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for diagnosis and classification and are aware of its advantages in terms of communication and treatment planning. On the other hand, diagnostic classification systems, such as the DSM-IV, cannot always grasp the full clinical nuance of a patient's condition and the potential implications for treatment. Presenting symptoms may not always fit conveniently within a single diagnostic category and the “left out” symptoms may have clinical relevance. For instance, some patients who meet full DSM-IV criteria for major depressive disorder (MDD) may also present with subthreshold manic symptoms, such as increased energy or the reduced need for sleep at the same time. In current research terms, and for the future DSM-V criteria, these patients with subthreshold bipolarity are classified as MDD with “mixed” features.1–5

[学科分类] 精神健康和精神病学