Barcelona Bipolar and Depressive Disorders Program, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain.
Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University, Sant'Andrea University Hospital, UOC Psichiatria, Via di Grottarossa 1035-1039, Rome 00189, Italy.
Psychiatr Clin North Am. 2020 Mar;43(1):59-68. doi: 10.1016/j.psc.2019.10.006. Epub 2019 Nov 28.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition introduced the specifier "with mixed features" including 3 or more nonoverlapping typical manic symptoms during a major depressive episode in bipolar disorder type I or II or unipolar major depressive disorder. Excluding overlapping excitatory symptoms, which are frequently observed in mixed depression, leaves many patients with mixed depression undiagnosed. As a consequence, alternative diagnostic criteria have been proposed, claiming for the inclusion in the rubric of mixed features the following symptoms: psychomotor agitation, mood lability, and aggressiveness. A deeper diagnostic reconsideration of mixed features in depression should be provided by the new nosologic classification systems.
《精神障碍诊断与统计手册第五版》引入了“混合特征”的特征，包括在 I 型或 II 型双相情感障碍或单相重性抑郁障碍的重度抑郁发作期间出现 3 种或更多种非重叠的典型躁狂症状。排除混合性抑郁中经常观察到的重叠兴奋症状，使许多混合性抑郁患者得不到诊断。因此，提出了替代的诊断标准，主张将以下症状纳入混合特征的范畴：精神运动激越、情绪不稳定和攻击性。新的分类系统应该对抑郁中的混合特征进行更深入的诊断思考。
