2006 issue 2


Volume 15, issue 2

Review article

Development of the concept of mixed state in affective disorders - a historical perspective

Iwona Koszewska1
1. III Klinika Psychiatryczna Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2006; 15 (2): 105-93
Keywords: depression, mania, mixed state, affective bipolar disorder


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.

Address for correspondence:
Dr Iwona Koszewska, II Klinika Psychiatryczna Instytutu Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa