Bipolar Disorders: Mixed States, Rapid-Cycling, and Atypical Forms

203 Schizoaffective mixed statesThere are many similarities between schizoaffective and affective mixed episodes,but also relevant differences: for example, there are no gender differences inpatients having schizoaffective mixed episodes – perhaps a result of the impact ofthe schizo-element. The age at onset is lower, the duration of schizoaffective mixedepisodes can be longer, and the patients having schizoaffective mixed episodesexhibited more inability to work at a younger age.These results support the assumption that not only are schizoaffective mixedepisodes frequent, but they also represent the most severe form of bipolar disorderstanding on the top of a continuum – as we previously pointed out (Marneros,1999, 2000), and as is illustrated in Figure 8.10.REFERENCESAkiskal, H. S., Brieger, P., Mundt, C., et al. (2002). Temperament and affective disorders: theTEMPS-A scale brings American and European concepts together. Nervenarzt, 73, 262–71.American Psychiatric Association (1952). Diagnostic and Statistical Manual of Mental Disorders(DSM-I). Washington, DC: APA.American Psychiatric Association (1968). Diagnostic and Statistical Manual of Mental Disorders,2nd edn (DSM-II). Washington, DC: APA.American Psychiatric Association (1978). The Task Force on nomenclature and statistics of theAmerican Psychiatric Association DSM-III draft. Washington, DC: APA.American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders,3rd edn (DSM-III). Washington, DC: APA.American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders,3rd edn, revised (DSM-III-R). Washington, DC: APA.American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders,4th edn (DSM-IV). Washington, DC: APA.Beck, A. T., Ward, C. H., Mendelson, M., et al. (1961). An inventory for measuring depression.Arch. Gen. Psychiatry, 4, 561–71.Calabrese, J. R., Rapport, D. J., Findling, R. L., et al. (2000). Rapid-cycling bipolar disorder. InBipolar Disorders. 100 Years after Manic Depressive Insanity, ed. A. Marneros and J. Angst,pp. 89–109. Dordrecht: Kluwer Academic Publishers.Cannon-Spoor, H. E., Potkin, S. G., and Wyatt, R. J. (1982). Measurement of premorbid adjustmentin chronic schizophrenia. Schizophr. Bull., 8, 470–84.Costa, P. T. and McCrae, R. R. (1989). NEO PI/FFI Manual Supplement. Odessa: PsychologicalAssessment Resources.Fydrich, T., Renneberg, B., Schmitz, B., et al. (1997). SKID-II. Strukturiertes Klinisches Interviewfür DSM-IV. Achse II: Persönlichkeitsstörungen. Göttingen: Hogrefe.Jung, E., Krumm, B., Biehl, H., et al. (1989). Mannheimer Skala zur Einschätzung sozialerBehinderung (DAS-M). Weinheim: Beltz.Kahlbaum, K. (1863). Die Gruppirung der psychischen Krankheiten und die Eintheilung derSeelenstörungen. Danzig: Kafemann.