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Abstract：
Mixed depressive states are defined by the co-presence of depressive and manic symptoms. They represent extremely variable conditions from the point of view of clinical expressiveness and are difficult to recognize, ranging from clear schizophrenic-like psychoses and pseudodemented pictures to subsyndromal psychopathology. At the basis of the extreme variability of depressive pictures with mixed features are the different combinations that depressive and manic symptoms can assume. Furthermore, the intensity of depressive symptoms and manic symptoms, combined, can be variable, a factor that contributes to making the picture even more variable. Each form of mixed depressive state therefore presents its own specific symptomatic characteristics and specific difficulties in differential diagnosis and each form requires a different therapeutic strategy. In this work we have distinguished four possible specific subtypes of mixed depressive states, describing their specific clinical presentation and the therapeutic options most supported by the literature with the aim of contributing to a better recognition of mixed depressive states, to avoid incorrect diagnoses at patient and treatments that are useless if not worsening.
摘要：
混合抑郁状态由抑郁和躁狂症状的共存定义。从临床表达能力的角度来看，它们代表了极其可变的条件，并且很难识别，从明确的精神分裂症样精神病和假性痴呆图片到亚综合征精神病理学。基于具有混合特征的抑郁图片的极端可变性，是抑郁和躁狂症状可以假设的不同组合。此外，抑郁症状和躁狂症状的强度，合并,可以是可变的，一个因素，有助于使图片更加可变。因此，每种形式的混合抑郁状态都有其自身特定的症状特征和鉴别诊断的特定困难，每种形式都需要不同的治疗策略。在这项工作中，我们区分了混合抑郁状态的四种可能的特定亚型，描述他们的具体临床表现和治疗选择最支持的文献，目的是有助于更好地识别混合抑郁状态，以避免对患者的错误诊断和治疗，如果不恶化，这些治疗是无用的。
