Diagnosing and Managing Depressive Episodes in the DSM-5 Era
Current Psychiatry. 2015 October;14(10)
The premise of the newly introduced mixed features specifier in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is similar to what was proposed approximately a century ago as part of the “manic depression” unification hypothesis. German psychiatrist Emil Kraepelin (1856–1926) originally conceptualized affective states as a continuum, wherein an individual’s diagnosis was arrived at via a confluence of contemporaneous disturbances in mood, thought processes, and volition (behavior). His original description was agnostic insofar as it lacked the 2 categorical constructs, bipolar disorder and major depressive disorder—terms that eventually appeared in the DSM.