Mixed Features in Bipolar Disorder: assessing symptoms profiles and their relation with DSM-5 criteria

Introduction Mixed states, the co-occurrence of manic and depressive symptoms, were recognized described from time antiquity. DSM-5 first, DSM-5-TR after, introduced ‘’mixed features’’ specifier, defined by presence at least three non-overlapping opposite-pole symptoms during a syndromic depressive, hypomanic, or episode. Various manifestations, including irritability, distractibility, anxiety, psychomotor agitation, excluded since they can occur both hypo/manic episodes other mental illnesses. Objectives The objective this study was to evaluate phenomenology prevalence mixed states among bipolar disorder (BD) patients. We first assessed frequency specific features different mood states. Then, we estimated applying criteria, comparing it qualitatively with one detected psychometric questionnaires. Methods In naturalistic study, 903 adult outpatients BD participating in Stanley Foundation Bipolar Network followed longitudinally across 14,213 visits for 7 years. scores Inventory Depressive Symptomatology–Clinician-Rated Version (IDS-C) Young Mania Rating Scale (YMRS), administered each visit, used define episode assess symptoms. addition, applied criteria “with features” our sample, examine DSM-5-based construct. Results Specific symptomatic profiles differentiate pure ones (Figure 1 2). Mainly, higher irritability found episodes, hypo/manic, compared depression (0.60 vs. 1.20, p < 0,001) hypo/mania (0.82 1.54, 0,001), as reported 6th item IDS-C. Figure 1. Individual YMRS items depression, hypo/mania. 2. IDS-C Image: Image 2: Conclusions Preliminary results present showed that like are strongly prevalent Moreover, diagnostic specifier any lower rates hence may yield inadequate sensitivity recognizing patients suffering such conditions. Disclosure Interest None Declared