Mixed affective states: a diagnostic and therapeutic challenge

Author/s
Saurab Singh, Jasmine H. Y. Ho, Mark Agius
Citation
Issue 3 Summer 2013
CEPiP.2013;1:195-197
Abstract

Mixed affective states are important phases in bipolar affective disorder. This paper describes the nature of these states and their importance, which is because of the increased risk of suicidal thoughts and actions. Stopping antidepressants, optimising treatment with mood stabilisers and adding an atypical antipsychotic to treatment is effective in treating mixed affective states, reducing suicidal ideation and actions.

Keywords: mixed affective state, mixed bipolar depression, dysphoric mania, antidepressants, mangement of mixed affective state, antipsychotics

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):195-197; https://doi.org/10.65031/vqmo4240

References

  1. Rihmer Z, Gonda X. Prediction and prevention of suicide in bipolar illness. The second dual congress on Psychiatry and the Neurosciences, 1st European Congress of the International Neuropsychiatric Association; 2nd Mediterranean congress of the World Federation of Societies of Biological Psychiatry Athens 2006;Book of Abstracts:p 30.
  2. Agius M. The Consequences of the Model of the Bipolar Spectrum for the Choice of Treatment for Bipolar Illness. Psychiatrie 11 2007;Suppl4:8-12.
  3. Akiskal HS, Benazzi F, Perugi G, Rihmer Z. Agitated “unipolar” depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy. J Affect Disord. 2005;85 (3):245-58. https://doi.org/10.1016/j.jad.2004.12.004
  4. Tavormina G, Agius M. A study of the incidence of bipolar spectrum disorders in a private psychiatric practice. PsychiatrDanub. 2007;19 (4):370-4.
  5. Akiskal HS, Djenderedjian AM, Rosenthal RH, Khani MK. Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group. Am J Psychiatry 1977;134 (11):1227-33. https://doi.org/10.1176/ajp.134.11.1227
  6. Balázs 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 Affect Disord. 2006;91 (2-3):133-8 https://doi.org/10.1016/j.jad.2005.12.049
  7. Thuile J, Even C, Guelfi JD. Mixed states in bipolar disorders: a review of current therapeutic strategies. Encephale 2005;31 (5 Pt 1):617-23.          
  8. Ho J, Singh S, Agius M, Zaman R. Mixed affective states: a study within a community mental health team with treatment recommendations. Psychiatr Danub. 2011 Sep;23 Suppl 1:S25-8. https://doi.org/10.1016/s0924-9338(11)71899-5