Objective. To outline the historical development of the concept of mixed states in affective disorder, from antiquity to the present.
Background. The ICD-10 and DSM-IV diagnostic criteria for mixed states in bipolar disorder have been criticized in recent years. Since the times of Kraepelin mutual relations between depression and mania have been questionable. Mixed states, neglected for many years, become again an object of scientific investigation in recent years. One of the reasons for this rekindled interest is a probability that these states may be induced by antipsychotics.
Conclusions. The diagnostics of mixed states in the course of bipolar affective disorder is important in view of the need for their appropriate therapeutic management.