This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Jonathan M. Himmelhoch, MD; Dawood Mulla, MD; John F. Neil, MD; Thomas P. Detre, MD; David J. Kupfer, MD

Arch Gen Psychiatry. 1976;33(9):1062-1066.

Abstract
• The simultaneous existence of manic and depressive symptoms in a manic-depressive patient was first described by Kraepelin.¹ This so-called mixed state has come to have much theoretical significance in recent hypotheses about the nature of bipolar affective disorders.

In this investigation a mixed state is shown to be the initial episode in 31% of 84 manic-depressive outpatients. Moreover, the presence of "mixed" features does not correlate with severity of illness or mood circularity, but does correlate with sedative abuse and poor response to psychopharmacologic treatment. These results suggest that the "continuum hypothesis" and its satellite theories represent viable conceptualizations of the nature of manic-depressive illness.

Author Affiliations
From the Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic.

Footnotes
Accepted for publication Jan 28, 1976.

Reprint requests to Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15261 (Dr Himmelhoch).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

References
APPI Online CME 2007;2007:2-2.
FULL TEXT  

Effects of Co-occurring Alcohol Abuse on the Course of Bipolar Disorder Following a First Hospitalization for Mania
Strakowski et al.
Arch Gen Psychiatry 2005;62:851-858.
ABSTRACT | FULL TEXT  

Efficacy of olanzapine combined with valproate or lithium in the treatment of dysphoric mania
Baker et al.
Br. J. Psychiatry 2004;185:472-478.
ABSTRACT | FULL TEXT  

12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
Keck et al.
Focus 2003;1:44-52.
ABSTRACT | FULL TEXT  

Syndromes and Phenomenological Subtypes Underlying Acute Mania: A Factor Analytic Study of 576 Manic Patients
Sato et al.
Am. J. Psychiatry 2002;159:968-974.
ABSTRACT | FULL TEXT  

Use of antipsychotic drugs and lithium in mania
COOKSON
Br. J. Psychiatry 2001;178 :s148-s156.
ABSTRACT | FULL TEXT  

Psychopharmacologic Treatment Strategies for Depression, Bipolar Disorder, and Schizophrenia
Glick et al.
ANN INTERN MED 2001;134:47-60.
ABSTRACT | FULL TEXT  

12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
Keck et al.
Am. J. Psychiatry 1998;155:646-652.
ABSTRACT | FULL TEXT  

Current Therapeutic Profile of Lithium
Gershon and Soares
Arch Gen Psychiatry 1997;54:16-20.
ABSTRACT  

Pharmacologic Treatment of Bipolar Disorder Through the Life Cycle
Jackson
Journal of Pharmacy Practice 1996;9:95-103.
ABSTRACT  

Progress in Psychiatry- Second of Two Parts
Michels and Marzuk
NEJM 1993;329:628-638.
FULL TEXT  

Outcome in Mania: A 4-Year Prospective Follow-up of 75 Patients Utilizing Survival Analysis
Tohen et al.
Arch Gen Psychiatry 1990;47:1106-1111.
ABSTRACT  

Lithium Carbonate Treatment of Mania: Cerebrospinal Fluid and Urinary Monoamine Metabolites and Treatment Outcome
Swann et al.
Arch Gen Psychiatry 1987;44:345-354.
ABSTRACT  

Secondary Mania: Manic Syndromes Associated With Antecedent Physical Illness or Drugs
Krauthammer and Klerman
Arch Gen Psychiatry 1978;35:1333-1339.
ABSTRACT