274 P. BriegerHimmelhoch, J. M., Mulla, D., Neil, J. F., Detre, T. P., <strong>and</strong> Kupfer, D. J. (1976). Incidence <strong>and</strong>signficiance of mixed affective states in a bipolar population. Arch. Gen. Psychiatry, 33,1062–6.Jan, J. E., Abroms I. F., Freeman, R. D., et al. (1994). <strong>Rapid</strong> cycling in severely multidisabledchildren: a form of bipolar affective disorder? Pediatr. Neurol., 10, 34–9.Jaspers, K. (1973). Allgemeine Psychopathologie, 9th edn. Berlin: Springer.Joffe, R. T., Kutcher, S. <strong>and</strong> MacDonald, C. (1988). Thyroid function <strong>and</strong> bipolar affectivedisorder. Psychiatry Res., 25, 117–21.Joffe, R. T., Young, L. T., Cooke, R. G., <strong>and</strong> Robb, J. (1994). The thyroid <strong>and</strong> mixed affectivestates. Acta Psychiatr. Sc<strong>and</strong>., 90, 131–2.Kahlbaum, K. L. (1863). Die Gruppierung der psychischen Krankheiten und die Einteilung derSeelenstörungen. Danzig: A. W. Kafemann.Keller, M. B., Lavori, P. W., Coryell, W., et al. (1986). Differential outcome of pure manic, mixed/cycling, <strong>and</strong> pure depressive episodes in patients with bipolar illness. J. A. M. A., 255, 3138–42.Kessler, R. C. (1999). Comorbidity of unipolar <strong>and</strong> bipolar depression with other psychiatricdisorders in a general population survey. In Comorbidity in Affective <strong>Disorders</strong>, ed. M. Tohen,pp. 1–25 New York: Marcel Dekker.Klerman, G. L. (1990). Approaches to the phenomena of comorbidity. In Comorbidity of Mood<strong>and</strong> Anxiety <strong>Disorders</strong>, ed. J. D. Maser <strong>and</strong> C. R. Cloninger, pp. 13–37. Washington, DC:American Psychiatric Press.Koukopoulos, A. <strong>and</strong> Koukopoulos, A. (1999). Agitated depression as a mixed state <strong>and</strong> theproblem of melancholia. Psychiatr. Clin. North Am., 22, 547–64.Kraepelin, E. (1909–1915). Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 8 Aufl. Leipzig:Johann Ambrosius Barth.Kudo, T., Ishida, S., Kubota, H., <strong>and</strong> Yagi, K. (2001). Manic episode in epilepsy <strong>and</strong> bipolar Idisorder: a comparative analysis of 13 patients. Epilepsia, 42, 1036–42.Kupka, R. W., Nolen, W. A., Post, R. M., et al. (2002). High rate of autoimmune thyroiditis inbipolar disorder: lack of association with lithium exposure. Biol. Psychiatry, 51, 305–11.Lauterbach, E. C., Spears, T. E., <strong>and</strong> Price, S. T. (1992). <strong>Bipolar</strong> disorder in idiopathic dystonia:clinical features <strong>and</strong> possible neurobiology. J. Neuropsychiatry Clin. Neurosci., 4, 435–9.Lish, J. D., Gyulai, L., Resnick, S. M., et al. (1993). A family history study of rapid-cycling bipolardisorder. Psychiatry Res., 48, 37–46.Livesley, W. J. (1998). Suggestions for a framework for an empirically based classification ofpersonality disorder. Can. J. Psychiatry, 43, 137–47.Marneros, A. <strong>and</strong> Brieger, P. (2002). The prognosis of bipolar disorder: a review. In <strong>Bipolar</strong><strong>Disorders</strong>. WPA series vol. 5, ed. M. Maj, N. Sartorius, J.-J. L. Ibor, <strong>and</strong> H. S. Akiskal,pp. 97–148, Chichester: Wiley.Maser, J. <strong>and</strong> Patterson, T. (2002). Spectrum <strong>and</strong> nosology: implications for DSM-V. Psychiatr.Clin. North America., 25, 855–85.McDermut, W., Mattia, J. <strong>and</strong> Zimmerman, M. (2001). Comorbidity burden <strong>and</strong> its impact onpsychosocial morbidity in depressed outpatients. J. Affect. Disord., 65, 289–95.McElroy, S. L., Strakowski, S. M., Keck, P. E., Jr., et al. (1995). Differences <strong>and</strong> similarities inmixed <strong>and</strong> pure mania. Compr. Psychiatry, 36, 187–94.
275 Comorbidity in mixed states <strong>and</strong> rapid-cycling disordersMcElroy, S. L., Freeman, M. P., <strong>and</strong> Akiskal, H. S. (2000). The mixed bipolar disorders. In<strong>Bipolar</strong> <strong>Disorders</strong>: 100 Years after Manic-Depressive Insanity. ed. A. Marneros <strong>and</strong> J. Angst,pp. 63–88 Dordrecht: Kluwer Academic Publishers.McElroy, S. L., Altshuler, L. L., Suppes, T., et al. (2001). Axis I psychiatric comorbidity <strong>and</strong> itsrelationship to historical illness variables in 288 patients with bipolar disorder. Am. J.Psychiatry, 158, 420–6.Merikangas, K. R. (1990). Comorbidity for anxiety <strong>and</strong> depression: reviews of family <strong>and</strong> geneticstudies. In Comorbidity of Mood <strong>and</strong> Anxiety <strong>Disorders</strong>, ed. J. D. Maser <strong>and</strong> C. R. Cloninger,pp. 331–48. Washington, DC: American Psychiatric Press.Oomen, H. A., Schipperijn, A. J., <strong>and</strong> Drexhage, H. A. (1996). The prevalence of affectivedisorder <strong>and</strong> in particular of a rapid cycling of bipolar disorder in patients with abnormalthyroid function tests. Clin. Endocrinol. (Oxf.), 45, 215–23.Perugi, G., Toni, C., <strong>and</strong> Akiskal, H. (1999). Anxious-bipolar comorbidity. Diagnostic <strong>and</strong>treatment challenges. Psychiatr. Clin. North Am., 22, 565–83.Perugi, G., Akiskal, H. S., Toni, C., Simonini, E. <strong>and</strong> Gemignani, A. (2001). The temporalrelationship between anxiety disorders <strong>and</strong> (hypo)mania: a retrospective examination of 63manic, social phobic <strong>and</strong> obsessive-compulsive patients with comorbid bipolar disorder.J. Affect. Disord., 67, 199–206.Post, R. M., Rubinow, D. R., Uhde, T. W., et al. (1989). Dysphoric mania. Clinical <strong>and</strong> biologicalcorrelates. Arch. Gen. Psychiatry, 46, 353–8.Raghavan, R., Day, K. A., <strong>and</strong> Perry, R. H. (1995). <strong>Rapid</strong> cycling bipolar affective disorder <strong>and</strong>familial learning disability associated with temporal lobe (occipitotemporal gyrus) corticaldysplasia. J. Intellect. Disabil. Res., 39, 509–19.Reinelt, Y. (2003). Paraklinische Befunde bei gemischten Episoden bipolar affektiver und schizoaffektiverErkrankungen. [Paraclinical findings in patients with mixed bipolar affective <strong>and</strong>mixed bipolar schizoaffective episodes.] Medical thesis. Halle/Saale: Martin-Luther-UniversityHalle-Wittenberg.Rundell, J. R. <strong>and</strong> Wise, M. G. (1989). Causes of organic mood disorder. J. Neuropsychiatry Clin.Neurosci., 1, 398–400.Sonne, S. C. <strong>and</strong> Brady, K. T. (1999). <strong>Bipolar</strong> disorder <strong>and</strong> substance abuse. In Comorbidity inAffective <strong>Disorders</strong>, ed. M. Tohen, pp. 197–212. New York; Marcel Dekker.Sonne, S. C., Brady, K. T., <strong>and</strong> Morton, W. A. (1994). Substance abuse <strong>and</strong> bipolar affectivedisorder. J. Nerv. Ment. Dis., 182, 349–52.Spitzer, R. L. (1998). Diagnosis <strong>and</strong> need for treatment are not the same. Arch. Gen. Psychiatry,55, 120.Strakowski, S. M., Tohen, M., Stoll, A. L., Faedda, G. L., <strong>and</strong> Goodwin, D. C. (1992).Comorbidity in mania at first hospitalization. Am. J. Psychiatry, 149, 554–6.Strakowski, S. M., Sax, K. W., McElroy, S. L., et al. (1998). Course of psychiatric <strong>and</strong> substanceabuse syndromes co-occurring with bipolar disorder after a first psychiatric hospitalization.J. Clin. Psychiatry, 59, 465–71.Swann, A. C., Secunda, S. K., Katz, M. M., et al. (1993). Specificity of mixed affectivestates: clinical comparison of dysphoric mania <strong>and</strong> agitated depression. J. Affect. Disord.,28, 81–9.
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Bipolar DisordersMixed States, Rapi
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ContentsList of contributorsPreface
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ContributorsValadeta Ajdacic PhDPsy
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ixList of contributorsAlexia E. Kou
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PrefaceBipolar disorders have a lon
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2 A. Marneros and F. K. Goodwinold
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4 A. Marneros and F. K. GoodwinFig.
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6 A. Marneros and F. K. GoodwinThe
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8 A. Marneros and F. K. GoodwinFig.
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22 A. Marneros and F. K. Goodwinons
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24 A. Marneros and F. K. GoodwinFig
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26 A. Marneros and F. K. Goodwinbou
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28 A. Marneros and F. K. GoodwinAno
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30 A. Marneros and F. K. GoodwinTab
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32 A. Marneros and F. K. GoodwinBip
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34 A. Marneros and F. K. GoodwinTab
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36 A. Marneros and F. K. GoodwinTab
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38 A. Marneros and F. K. GoodwinAki
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40 A. Marneros and F. K. GoodwinDil
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42 A. Marneros and F. K. GoodwinMar
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44 A. Marneros and F. K. GoodwinPri
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46 G. Perugi and H. S. AkiskalTable
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48 G. Perugi and H. S. AkiskalTable
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50 G. Perugi and H. S. AkiskalDepre
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52 G. Perugi and H. S. Akiskalwith
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54 G. Perugi and H. S. Akiskal3020.
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56 G. Perugi and H. S. AkiskalTable
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59 Longitudinal perspective of mixe
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3Rapid-cycling bipolar disorder1 2O
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63 Rapid-cycling bipolar disorderPs
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65 Rapid-cycling bipolar disorderOn
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67 Rapid-cycling bipolar disorderBr
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69 Rapid-cycling bipolar disorderin
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71 Rapid-cycling bipolar disorderLa
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73 Rapid-cycling bipolar disorderre
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75 Rapid-cycling bipolar disorderCo
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77 Rapid-cycling bipolar disorderDe
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79 Rapid-cycling bipolar disorderan
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81 Rapid-cycling bipolar disorderTa
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83 Rapid-cycling bipolar disorderRE
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85 Rapid-cycling bipolar disorderJo
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87 Rapid-cycling bipolar disorderde
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89 Bipolar I and bipolar II: a dich
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91 Bipolar I and bipolar II: a dich
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93 Bipolar I and bipolar II: a dich
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95 Bipolar I and bipolar II: a dich
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97 Bipolar I and bipolar II: a dich
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99 Bipolar I and bipolar II: a dich
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101 Bipolar I and bipolar II: a dic
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103 Bipolar I and bipolar II: a dic
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105 Bipolar I and bipolar II: a dic
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107 Bipolar I and bipolar II: a dic
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5Recurrent brief depression as an i
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111 Recurrent brief depressionRecur
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113 Recurrent brief depressionbeen
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115 Recurrent brief depressioncorre
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117 Recurrent brief depressionThere
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Chronic 4.8 18.2 9.1 10 NCRapid-cyc
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121 Recurrent brief depressionTable
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123 Recurrent brief depressionPreva
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125 Recurrent brief depressionWe fo
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127 Recurrent brief depressionREFER
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129 Recurrent brief depressionMarne
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6Atypical depression and its relati
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133 Atypical depression and bipolar
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135 Atypical depression and bipolar
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137 Atypical depression and bipolar
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139 Atypical depression and bipolar
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141 Atypical depression and bipolar
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143 Atypical depression and bipolar
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145 Atypical depression and bipolar
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147 Atypical depression and bipolar
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149 Atypical depression and bipolar
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151 Atypical depression and bipolar
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153 Atypical depression and bipolar
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155 Atypical depression and bipolar
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7Agitated depression: spontaneous a
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159 Agitated depression: spontaneou
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161 Agitated depression: spontaneou
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163 Agitated depression: spontaneou
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165 Agitated depression: spontaneou
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167 Agitated depression: spontaneou
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169 Agitated depression: spontaneou
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171 Agitated depression: spontaneou
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173 Agitated depression: spontaneou
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175 Agitated depression: spontaneou
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177 Agitated depression: spontaneou
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179 Agitated depression: spontaneou
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181 Agitated depression: spontaneou
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183 Agitated depression: spontaneou
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185 Agitated depression: spontaneou
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8Schizoaffective mixed statesAndrea
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189 Schizoaffective mixed statescon
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191 Schizoaffective mixed stateswas
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193 Schizoaffective mixed statesUni
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195 Schizoaffective mixed statesTab
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197 Schizoaffective mixed statesday
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199 Schizoaffective mixed statesTot
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201 Schizoaffective mixed statesBip
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203 Schizoaffective mixed statesThe
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205 Schizoaffective mixed statesMar
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9Acute and transient psychotic diso
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209 Acute and transient psychotic d
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211 Acute and transient psychotic d
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213 Acute and transient psychotic d
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215 Acute and transient psychotic d
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217 Acute and transient psychotic d
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219 Acute and transient psychotic d
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221 Acute and transient psychotic d
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- Page 291 and 292: 13Challenges in the genetics of bip
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325 The treatment of bipolar mixed
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327 The treatment of bipolar mixed
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329 The treatment of bipolar mixed
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331 The treatment of bipolar mixed
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333 The treatment of bipolar mixed
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335 The treatment of bipolar mixed
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337 The treatment of bipolar mixed
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339 The treatment of bipolar mixed
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341 The treatment of bipolar mixed
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343 The treatment of bipolar mixed
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345 The treatment of bipolar mixed
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347 The treatment of bipolar mixed
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349 The treatment of bipolar mixed
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351 The treatment of bipolar mixed
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16The use of atypical antipsychotic
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355 Use of atypical antipsychotic a
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357 Use of atypical antipsychotic a
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359 Use of atypical antipsychotic a
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361 Use of atypical antipsychotic a
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363 Use of atypical antipsychotic a
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365 Use of atypical antipsychotic a
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367 Use of atypical antipsychotic a
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17Investigational strategies: treat
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371 Investigational strategiesBIPOL
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373 Investigational strategiesinsta
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375 Investigational strategiesWhat
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377 Investigational strategiesTable
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379 Investigational strategiescateg
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381 Investigational strategiesTable
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383 Investigational strategies2. Th
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385 Investigational strategiesSachs
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387 Indexclinical course and outcom
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389 Indexdepressive mixed states 51
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391 IndexLange, J. 163learning disa
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393 Indexpsychopharmacological revo
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395 Indexmania, acute 334mixed stat