DIFFERENCES AND SIMILARITIES IN MIXED AND PURE MANIA

The aim of this study was to examine the relationship between mixed an d pure mania using both narrow (DSM-III-R) and broad (Cincinnati) oper ational diagnostic criteria to define mixed mania regarding the degree of associated depression. Hospitalized patients aged greater than or equal to 12 years and meeting DSM-III-R criteria for bipolar disorder, manic or mixed, were compared regarding demographics, phenomenology, course of illness, comorbidity, family history, and short term outcome . Seventy-one patients were recruited during a 1-year period. Twenty-f our patients (34%) met DSM-III-R criteria for mixed bipolar disorder; 28 (40%) met the broader definition (which required three associated d epressive symptoms rather than full syndromal DSM-III-R depression), C ompared with pure manic patients, DSM-III-R mixed patients had signifi cantly more depressive symptoms, were more likely to be female, experi enced more prior mixed episodes, displayed higher rates of comorbid ob sessive-compulsive disorder, and had longer hospitalizations. However, when mixed mania was defined more broadly, differences in gender and hospitalization length were lost. Also, regardless of the definition u sed, mixed and pure manic patients were similar on most other variable s assessed. We conclude that mixed and pure mania differ in some respe cts but have many similarities, especially when mixed mania is defined by lesser degrees of depression, The use of dimensional rather than c ategoric systems to describe the degree of associated depression may b e a more meaningful method of classifying mania. Copyright (C) 1995 by W.B. Saunders Company