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ID 114014
タイトル別表記
Diagnosis & treatment of mixed depression
著者
Kondo, Tsuyoshi University of the Ryukyus
Shinzato, Hotaka University of the Ryukyus
キーワード
mixed depression
irritability
distractibility
agitation
diagnosis
pharmacotherapy
資料タイプ
学術雑誌論文
抄録
Although the definition of depressive mixed state, more commonly known as mixed depression, is still controversial, about one-third of major depressive episodes are held to contain mixed components. The most frequent manifestations of mixed depression are irritability, distractibility and psychomotor agitation, although these symptoms are not included in the mixed features during a major depressive episode according to the DSM-5 criteria, which is therefore unlikely to cover the full scope of mixed depression in real-world settings. Mixed depression often accompanies risky behavior including impulsive suicide attempts. The early detection and treatment of these unstable conditions is therefore necessary. Also, sufficiently sensitive and specific screening methods for depressive mixed state are needed to avoid both under- and over-diagnosis. Antidepressants should be avoided since these drugs often worsen irritability, agitation and impulsivity, and increase risky behavior. Instead, combination therapy with mood stabilizer(s) to prevent the relapse of the depressive mixed state and atypical antipsychotics for rapid stabilization in the acute phase should be considered. Because there is very little evidence for effective pharmacotherapy in mixed depression, the efficacy of various mood-stabilizing agents, either as monotherapy or in combination therapies, should be extensively examined in the future using quantitative assessments of the psychopathology of mixed depression in patients with confirmed diagnoses of mixed depression.
掲載誌名
Clinical Neuropsychopharmacology and Therapeutics
ISSN
18848826
出版者
The Japanese Society of Clinical Neuropsychopharmacology
7
開始ページ
41
終了ページ
47
発行日
2016-08-19
権利情報
this article is distributed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0)(Attribution-NonCommercial 4.0 International)(https://creativecommons.org/licenses/by-nc/4.0/)
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
総合科学系