SPECIFICITY OF MIXED AFFECTIVE STATES - CLINICAL COMPARISON OF DYSPHORIC MANIA AND AGITATED DEPRESSION

To investigate the clinical specificity of mixed affective states, we compared clinical characteristics of mixed (dysphoric) manics to those of agitated depressed patients. The subjects were inpatients studied in the NIMH Clinical Research Branch Collaborative Study on the Psycho biology of Depression, Biological Studies. Behavior and symptom rating s for depressive and manic symptoms were obtained during a 15-day plac ebo washout period. Patients with agitated depression were compared to those in acute manic episodes with and without prominent depressive s ymptoms. Mania ratings clearly distinguished agitated depressed from m ixed manic patients. Concerning depression and general psychopathology , mixed manics had more severe agitation, hostility and cognitive impa irment than did agitated depressed patients. Depressed mood and anxiet y did not differ significantly between the two groups. Nurse ratings f or depression and anxiety, based on ward behavior, were similar for mi xed manics and agitated depressed patients, while physician-interview rated depression and anxiety were higher in agitated depressed patient s. These data support the existence of superimposed depressive and man ic syndromes in mixed manics.