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The boundary between mixed and manic episodes in the ICD-10 classification

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Objective: To investigate the boundary between ICD-10 mixed and manic episodes, which has apparently remained understudied.

Method: In-patients with ICD-10 mixed (n=36) and manic episodes (n=145) were compared in terms of demographic, clinical, therapeutical and outcome variables.

Results: Of in-patients with manic episode, 26 (18%) had several depressive symptoms at admission. These patients (dysphoric manic patients) were very similar to patients with ICD-10 mixed episode in terms of current symptomatic presentations and several clinical and therapeutic variables, which were significantly different from those in patients with pure mania.

Conclusion: The ICD-10 boundary between mixed and manic episodes is unlikely to be effective although experienced clinicians made the diagnoses. The system may have a high probability of diagnosing dysphoric manic patients as having manic episode, despite their great similarities to patients with mixed episode in terms of current psychopathological presentations as well as clinically important variables.
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Keywords: bipolar disorder; mixed states; mood disorders

Document Type: Research Article

Affiliations: Psychiatrische Klinik und Poliklinik, LMU Munich, Germany

Publication date: 01 August 2002

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