Melancholia agitata and mixed depression.
OBJECTIVE
The diagnostic entity of major depressive episode includes both simple and agitated or mixed depression. Mixed depression is characterized by a full depressive episode with several symptoms of excitatory nature. Mixed depressions worsen if treated with antidepressants.


METHODS
We have reviewed the clinical charts of the 2141 patients treated at the Centro Lucio Bini of Rome from January 1999 to June 2006. These patients were diagnosed according to DSM-IV criteria. Research diagnostic criteria were applied for agitated depression with motor agitation and Author's diagnostic criteria for agitated depression without motor agitation.


RESULTS
One thousand and twenty-six patients had a depressive episode as index episode. Three hundred and forty six (33%) were mixed depressive states. One hundred and thirty eight (44%) of them were spontaneous; in 173 cases, the onset of the mixed depression was associated with antidepressants.


CONCLUSIONS
Psychic and motor agitation are considered equally important for the definition of agitated depression. Treating agitated depression with antidepressants worsens the clinical picture. The use of Electroconvulsive Therapy (ECT), neuroleptics and anticonvulsants are recommended. The term Melancholia Agitata is proposed for agitated (mixed) depression.
Koukopoulos
A
A
Centro Lucio Bini, Center for the Treatment and Research of Affective Disorders and Department of Psychiatry, University of Rome La Sapienza, c/o Sant'Andrea Hospital, Rome, Italy. a.koukopoulos@fastwebnet.it
Sani
G
G
Koukopoulos
A E
AE
Manfredi
G
G
Pacchiarotti
I
I
Girardi
P
P
D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D009626:Terminology as Topic
D000928:Antidepressive Agents