Presented at the Conference: ‘Melancholia: Beyond DSM, Beyond Neurotransmitters’, May 2–4, 2006, Copenhagen, Denmark
Melancholia agitata and mixed depression
Article first published online: 15 JAN 2007
Acta Psychiatrica Scandinavica
Volume 115, Issue Supplement s433, pages 50–57, February 2007
How to Cite
Koukopoulos, A., Sani, G., Koukopoulos, A. E., Manfredi, G., Pacchiarotti, I. and Girardi, P. (2007), Melancholia agitata and mixed depression. Acta Psychiatrica Scandinavica, 115: 50–57. doi: 10.1111/j.1600-0447.2007.00963.x
- Issue published online: 15 JAN 2007
- Article first published online: 15 JAN 2007
- mixed depressive states;
- agitated depression;
- melancholia agitata;
Objective: The diagnostic entity of major depressive episode includes both simple and agitated or mixed depression. Mixed depression is characterized by a full depressive episode with several symptoms of excitatory nature. Mixed depressions worsen if treated with antidepressants.
Method: We have reviewed the clinical charts of the 2141 patients treated at the Centro Lucio Bini of Rome from January 1999 to June 2006. These patients were diagnosed according to DSM-IV criteria. Research diagnostic criteria were applied for agitated depression with motor agitation and Author's diagnostic criteria for agitated depression without motor agitation.
Results: One thousand and twenty-six patients had a depressive episode as index episode. Three hundred and forty six (33%) were mixed depressive states. One hundred and thirty eight (44%) of them were spontaneous; in 173 cases, the onset of the mixed depression was associated with antidepressants.
Conclusion: Psychic and motor agitation are considered equally important for the definition of agitated depression. Treating agitated depression with antidepressants worsens the clinical picture. The use of Electroconvulsive Therapy (ECT), neuroleptics and anticonvulsants are recommended. The term Melancholia Agitata is proposed for agitated (mixed) depression.