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Exact(5)

The number of previous mixed episodes was associated with a worse response (p = 0.026).

Episode frequency was calculated by an computer program according to DSM-IV criteria for mania, hypomania, depression, and mixed episodes was based on prospective daily mood ratings with the life chart methodology (LCM) (Kupka et al. 2005; Denicoff et al. 1997).

No recurrence of mixed episodes was noted in this study.

In 2013, the first meta-analysis of the efficacy of SGAs in mixed episodes was published, suggesting that some of these drugs are effective in reducing not only manic but also depressive symptoms in patients with mixed episodes [ 14].

The finding of a mood stabilizer(s) plus an antipsychotic(s) as the most commonly prescribed pattern (more than 50%) in our study is consistent with a previous report that polypharmacy for acute manic and mixed episodes was a common phenomenon [ 24].

Similar(55)

Mixed episodes are reported in up to 40% of acute bipolar admissions and are associated with severe psychopathology, comorbidity, high risk of suicide and poor treatment response.

Methods: Patients with a diagnosis of bipolar I disorder with manic or mixed episodes were enrolled in a randomized controlled trial.

In this sample, though both rapid cycling and mixed episodes were associated with suicide attempts, rapid cycling and mixed episodes were distinct from each other.

Another limitation is that BD subjects experiencing manic, hypomanic, or mixed episodes were excluded.

Mixed episodes were not considered in this study for determining predominant polarity.

As the analysis was performed considering the scales separately, mixed episodes were not explored, nor episode length.

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