title: Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder.
abstract: BACKGROUND
  Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment.
  
  
  METHODS
  The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment.
  
  
  RESULTS
  Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment.
  
  
  CONCLUSIONS
  This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder.
  
  
  CONCLUSIONS
  In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted.
authors.affiliation: Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Ronald
authors.initials: R
authors.lastname: Bottlender
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sato
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kleindienst
authors.forename: Anton
authors.initials: A
authors.lastname: Strauss
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Möller
mesh_terms: D001714:Bipolar Disorder / Q000628:therapy*; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance; D012189:Retrospective Studies