mixed episode


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episode

 [ep´ĭ-sōd]
a single noteworthy happening in the course of a longer series of events, such as one critical period of several during a prolonged illness.
hypomanic episode a period of elevated, expansive, or irritable mood similar to a manic episode but not as severe; see also bipolar disorders and mood disorders.
major depressive episode a period of daily and day-long depressed mood or loss of interest or pleasure in virtually all activities. Also present is some combination of altered appetite, weight, or sleep patterns, psychomotor agitation or retardation, difficulty thinking or concentrating, lack of energy and fatigue, feelings of worthlessness, self-reproach, or inappropriate guilt, recurrent thoughts of death or suicide, and plans or attempts to commit suicide. See also bipolar disorders and mood disorders.
manic episode a period of predominantly elevated, expansive, or irritable mood accompanied by some of the following symptoms: inflated self-esteem, decreased need for sleep, talkativeness, flight of ideas, distractibility, hyperactivity, hypersexuality, and recklessness. See also bipolar disorders and mood disorders.
mixed episode a period during which the criteria are met both for a major depressive episode and for a manic episode nearly every day, with rapidly alternating moods and with symptoms characteristic of each type of episode. See also bipolar disorders and mood disorders.

mixed episode

1. a manifestation of a major mood disorder involving simultaneous symptoms of a manic episode and a major depressive episode.
2. a DSM construct when specified criteria are met.
A period of 1 week in which the diagnostic criteria for manic and depressive episodes are met on nearly every day, with abrupt mood swings from sadness to irritability to euphoria

mixed episode

Psychiatry A period of ≥ 1 wk in which criteria for manic and depressive episodes are met on nearly every day, with abrupt mood swings from sadness, irritability, euphoria Clinical Agitation, insomnia, appetite dysregulation, psychotic features and suicidal ideation; MEs are of sufficient severity to cause impairment of social and occupational function and/or require hospitalization. See Bipolar disorder.

mix·ed ep·i·sode

(mikst epi-sōd)
Sign of a major mood disorder involving simultaneous symptoms of manic and major depressive episodes.
See: bipolar disorder, manic episode, major depressive disorder

mix·ed ep·i·sode

(mikst epi-sōd)
Manifestation of major mood disorder involving simultaneous symptoms of a manic episode and a major depressive episode.
References in periodicals archive ?
(28) A post hoc study evaluated asenapine and olanzapine in a subgroup of patients with bipolar I disorder and moderate-to-severe mixed major depressive episodes who met DSM-IV-TR criteria for mixed episodes. (29) Data came from subgroup analyses of results from two 3-week, randomized, placebo-controlled trials (N=489 and N=488).
For those individuals who suffered sexual violence, the probability of having depressive episodes was approximately two times higher when compared to those who did not suffer sexual violence (RP 1.94; CI 95% 1.10-3.41); for mixed episodes, the probability was 4 times higher (RP 3.92; CI 95% 1.48-10.32), while the probability of lifetime suicide risk was 2.8 times higher among individuals who suffered sexual violence (RP 2.83; CI 95% 1.76-4.54).
Emerging evidence indicates that in patients with BD, ziprasidone provides valid efficacy and remarkable safety when administered alone for the treatment of manic and mixed episodes. The same applies when ziprasidone is administered in combination with lithium or valproate for the prevention of affective recurrences and relapses.36
(26) Asenapine is provided in a rapidly absorbed, sublingual form and is FDA-approved for treating acute mania or mixed episodes associated with BDI.27 Overall, however, only slightly more than one-half of BD patients are adherent to atypical antipsychotics.
Mixed episodes may be difficult to identify, particularly when a clinician has not seen them before or when the patient's symptoms only partially meet the criteria for a mixed episode.
Details of the 5 industry-sponsored RCTs of atypical antipsychotics in children and adolescents with bipolar I manic or mixed episodes are summarized in Table 1 (page 24).
Based on a diagnosis of bipolar disorder, current episode mixed, and a phone consultation with a psychiatric colleague, the PCP determines that the appropriate way to treat Susan D is to prescribe a medication for mixed episodes of bipolar disorder.
What does the evidence say about the efficacy of mood stabilizers in treating all aspects of bipolar disorder acute mania, mixed episodes, and depression and in long-term treatment of bipolar illness?
Because a mixed episode can include elements of depression, and because the manic aspect of the episode may be characterized more by restless energy and irritability than by pure mania, it can be difficult to distinguish a mixed state from a simple depressive episode.
Patients who switched were significantly older at bipolar disorder onset; presented less often with a mixed episode at baseline; and had more depressive episodes, hospital admissions, and suicide attempts in the previous 12 months.
Primary outcomes were recurrence and number of clinical events (for example, a mixed episode or major depressive episode) assessed by an independent board.
McIntyre observed that one mixed episode is likely to be followed by others, and that the risk of depression is also heightened.