Detecting Mixed Features in Major Depression
W. Clay Jackson, MD, DipTh, explains the difference between major depressive disorder and major depressive disorder with mixed features after his Psych Congress 2019 presentation "Clinical Challenges in MDD: Addressing the Needs of Patients with Comorbid Disorders" with Psych Congress cochairs Rakesh Jain, MD, MPH, and Charles Raison, MD.
Dr. Jackson is a Clinical Assistant Professor of Family Medicine and Psychiatry at the University of Tennessee College of Medicine in Memphis, maintains a private practice in family medicine, and directs the palliative medicine program at the West Cancer Center in Arlington, Tennessee.
Read the Transcript:
The mixed feature nomenclature is new to DSM-5. Let's start with what's basic. That's MDD or major depressive disorder.
We start with a patient who's in a major depressive episode. They need to meet the criteria, one of the two primary criteria, and five of nine for a two-week period. That qualifies as an MDE, or major depressive episode.
That's where we start, and then when we add in the mixed features, it's a patient who meets MDE, or major depressive episode, criteria plus three of the manic symptoms.
When we have those together, that comprises a patient with MDD with mixed features.
Irritability, grandiosity, a decreased need for sleep, an increased rate or pressure of speech, those are some of the common things that we see.
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