To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Mixed bipolar states are not infrequent and may be extremely difficult to treat. Lithium, anticonvulsants including valproate and carbamazepine, and antipsychotics such as olanzapine, ziprasidone, and aripiprazole have been reported to be at least partially effective in controlled clinical trials, but many patients do not respond to pharmacological approaches. Electroconvulsive therapy has been tested to be efficacious for the treatment of both manic and depressive episodes, but much less evidence is available with regards to mixed states. The aim of the review was to report the available evidence for the use of electroconvulsive therapy in mixed bipolar states.
A systematic review of the literature on treatment of mixed states, focused on electroconvulsive therapy, was made, beginning in August 1992 and ending in March 2007. The key words were “electroconvulsive therapy” and “mixed bipolar”.
Only three studies met the required quality criteria and were included. This literature suggests that ECT is an effective, safe, and probably underutilized treatment of mixed states. Recent technical developments have made ECT more friendly, tolerable, and safe. Potential alternatives, such as vagus nerve stimulation, deep brain stimulation, or transcranial stimulation, are still far to be proved as effective as ECT.
Maria Reinares, Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona,
Eduard Vieta, Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona,
Antoni Benabarre, Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona,
Andreas Marneros, Department of Psychiatry and Psychotherapy, Martin Luther University, Halle-Wittenberg
The term “schizoaffective psychosis” was first introduced by Kasanin (1933) when he described a group of patients with good premorbid functioning who developed acute psychoses with a mixture of psychotic and affective symptoms, but fully recovered after a few months. While Kasanin is credited with introducing the term, it is defined differently now. Schizoaffective disorder is a complex illness whose definition has changed significantly over time. Despite the continued attempts to better define and classify schizoaffective disorder, much controversy and conflicting results remain. Unfortunately, schizoaffective disorders have been poorly investigated. Kahlbaum (1863) is usually considered the first psychiatrist in modern times to describe schizoaffective disorders as a separate group (Angst and Marneros, 2001). As Tsuang and Simpson (1984) reported, empirical findings are often contradictory and have at times supported the idea that schizoaffective disorder is (a) a variant of schizophrenia; (b) a variant of affective disorder; (c) a different and heterogeneous diagnostic group.
Regarding classification systems, in DSM-II schizoaffective disorder was included in the group of schizophrenic disorders, although some studies with controversial results were published (Procci, 1976; Harrow, 1984). While in DSM-III schizoaffective disorders had only the state of a remnant category, in DSM-III-R schizoaffective disorders were extended to a “true” entity with specific diagnostic criteria (Jäger et al., 2004).
Email your librarian or administrator to recommend adding this to your organisation's collection.