The article you requested is

Diagnosing and Treating Patients With Mixed Features

J Clin Psychiatry 2017;78(8):1091–1102
10.4088/JCP.su17009ah1c
​​Diagnosing and Treating Patients With Mixed Features

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Many patients with mood disorders do not experience pure episodes of depression or mania. Rather, these individuals experience mixed presentations. In the past, individuals experiencing mixed mood episodes were often misdiagnosed due to overly strict diagnostic criteria, leading to poor outcomes and treatment response. The addition of the mixed features specifier to the DSM-5 holds promise for improving recognition in patients who may be experiencing mixed symptoms. Furthermore, awareness has grown important warning signs that should be considered risk factors for progression to bipolar disorder and should warrant special clinical attention. Finally, guidelines for patients experiencing depression with mixed features have recently become available to help provide evidence-based treatment to this patient population.

From the Department of Psychiatry, Texas Tech University Health Sciences Center Medical School, Midland (Dr Jain), the Department of Neuropsychiatry and Behavioral Sciences, University of South Carolina School of Medicine, Greer (Dr Maletic), and the Mood Disorders Psychopharmacology Unit, University of Toronto, Ontario, Canada (Dr McIntyre).

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