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

388 Indexdepression, agitated (cont.)clinical picture 166–7minor agitated depression 168, 182diagnostic criteria 176drive, mood and thought 165–6flight of ideas, racing and crowded thoughts169–70latent agitated depression 179melancholia agitata 158–61mixed affective states 161–5nature and definition 174–6restlessness, inner agitation and anxiety171–3Rome studynosological diagnosis 177patients and method 176–7spontaneous and induced agitated depression177–8temperament, role of 173–4treatment 178, 179mixed episodes 180olanzapine 180outcomes 180depression, atypical (AD)characterization 33–6, 282agitated depression 34clinical features 36definition 34DSM-IV features 34hyperthymic depression 35recurrent brief anxiety 35recurrent brief depression 35recurrent brief hypomania 35polymorphic psychotic disorders 36relationship with bipolar II disorder 131–2age relationship 135, 137chronic depression, relationship with 138differences with non-AD 137early- versus late-onset 136, 138gender differences 138–41, 145, 149hypomania 135–6menopause 140–1mixed states, links with 139overactivity 135predictive relationship 136prevalence 134–5problems with DSM-IV criteria 132psychotic features 140recurrences 140review of recent literature 132–4severity 139unipolar versus bipolar 136–7San Diego studycomparison between atypical and non-atypicaldepression 143comparison between unipolar and bipolardepression 146conclusions 146–51discriminant analysis 147patients and interview 141–3predictive variables 147results 144–5setting 141statistics 144symptom associations 147, 148symptom comparison 148depression, chronicrelationship with atypical depression 138depression in children and adolescents,accompanying manic symptoms 240depression, recurrent brief (RBD) 35, 109–11, 126comorbidity 123nature of condition 124–5prevalence 123study definitionsbipolar spectrum 113combined syndromes 114depressive spectrum 113personality 114–15rapid cycling and seasonality 114recurrent brief psychiatric syndromes 113–14statistics 115treatment and distress 114study methodologydesign 112interviews 112–13sample 112study results 115, 122association with mood disorders 116associations with other psychiatric disorders121–2combined versus pure mood disorders 117–21gender differences 117, 122longitudinal associations 116mood disorder associations 121predictors of bipolar II disorder 116–17subclassification 118suicide attempts 122suicide risk 123–4treatment 125–6