Treating depressive mixed States in bipolar disorders.

Although not recognized as a diagnostic entity in the DSM-IV-TR, mixed depression is a common clinical presentation. To treat depressive mixed states, clinicians in both Europe and the United States have developed valuable, yet different, therapeutic strategies. For example, the European model focuses on resolving patients' hypomanic symptoms, while the American model treats patients in depressive mixed episodes similarly to those who have bipolar II disorder. Common treatment practices between the 2 paradigms include the art of adopting pharmacotherapeutic regimens that are tailored to the needs of each patient and frequent evaluation of the patient's progress.