A reevaluation of the possibility and characteristics in bipolar mania with mixed features: a retrospective chart review.

The aim of the present study was to reevaluate the feasibility of diagnosing a mixed features behind bipolar mania and to elucidate the clinical characteristics, treatment response, and course of the illness throughout a 12-month follow-up. The subjects (n=171) were inpatients diagnosed with bipolar I disorder, manic, between 2003 and 2010 and were classified into three groups: "mania" (n=67), "mania with probable mixed features" (n=79), and "mania with definite mixed features" (n=25). Diagnoses were in accordance with the Cincinnati criteria, which include the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision characteristics for a major depressive episode, except for agitation and insomnia. The charts of subjects were retrospectively reviewed for demographic and clinical characteristics prior to the index episode, clinical data regarding the index episode, and treatment courses over a 12-month follow-up period. Subjects in the mania with definite mixed features were more likely to be young at admission, to be female, to have a familial affective loading, and to have a history of suicidality relative to the mania. The results of the present study suggest the need for regular assessment of symptoms associated with both polarities during an episode in routine practice.