PDF(Pubmed)
Abstract：
The debate on mixed states (MS) has been intense for decades. However, several points remain controversial from a nosographic, diagnostic, and therapeutic point of view. The different perspectives that have emerged over the years have turned into a large, but heterogeneous, literature body. The present review aims to summarize the evidence on MS, with a particular focus on mixed depression (MxD), in order to provide a guide for clinicians and encourage the development of future research on the topic. First, we review the history of MS, focusing on their different interpretations and categorizations over the centuries. In this section, we also report alternative models to traditional nosography. Second, we describe the main clinical features of MxD and list the most reliable assessment tools. Finally, we summarize the recommendations provided by the main international guidelines for the treatment of MxD. Our review highlights that the different conceptualizations of MS and MxD, the variability of clinical pictures, and the heterogeneous response to pharmacological treatment make MxD a real challenge for clinicians. Further studies are needed to better characterize the phenotypes of patients with MxD to help clinicians in the management of this delicate condition.
摘要：
几十年来，关于混合国家（MS）的争论一直很激烈。然而,从nosographic来看，有几点仍然存在争议，诊断,和治疗观点。多年来出现的不同观点已经变成了一个大,但是异质的，文学体。本综述旨在总结MS的证据，特别关注混合性抑郁症(MxD)，以便为临床医生提供指导，并鼓励该主题未来研究的发展。首先,我们回顾MS的历史，专注于他们几个世纪以来的不同解释和分类。在本节中,我们还报告了传统鼻图的替代模型。第二,我们描述了MxD的主要临床特征,并列出了最可靠的评估工具.最后,我们总结了MxD治疗的主要国际指南提供的建议.我们的评论强调，MS和MxD的不同概念化，临床图片的可变性，对药物治疗的异质性反应使MxD成为临床医生的真正挑战。需要进一步的研究来更好地表征MxD患者的表型，以帮助临床医生管理这种微妙的疾病。
