Mixed features in DSM-5： problems and solutions / 四川精神卫生

ABSTRACT

This study contests the mixed states in diagnostic criteria for bipolar disorder and major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， and attempts to propose possible solutions. At present， the DSM-5 defined “mixed feature specifier” in bipolar disorder faces a number of problems in clinical use， particularly with regard to the classification of incidental features， which poses some clinical difficulties. DSM-5 abandons the previous standard setting which conform to the strict diagnostic thinking that both depression and mania exist together， and primarily captures three or more non-overlapping symptoms of the opposite pole in clinical diagnosis， but the difficulty in diagnosing the states or features resulting from the coexistence of two diametrically opposed symptoms or symptom clusters has still not been effectively addressed. In practice， clinical features of depressive episodes across participants with maniac disorder and manic episodes in depressive disorder within bipolar disorder pedigrees become atypical. Therefore， this paper focuses on the psychopathological features of the mixed profile and conducts analysis in the context of clinical practice and selected research perspectives， so as to propose some potentially constructive ideas to inform the solution of the clinical problems of the mixed states.