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Pharmacological treatment of mixed states

机译：混合状态的药理治疗

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Mixed states in bipolar disorder have been neglected, and the data concerning treatment of these conditions have been relatively obscure. To address this, we systematically reviewed published pharmacological treatment data for "mixed states/episodes"in mood disorders, including "with mixed features"in DSM-5. We searched PubMed, MEDLINE, The Cochrane Library, clinicaltrials. gov, and controlled-trials.com (with different combinations of the following keywords: "mixed states/features," "bipolar," "depressive symptoms/bipolar depression,""manic symptoms," "treatment," "DSM-5") through to October 2016. We applied a quality-of-evidence approach: first-degree evidence=randomized placebo-controlled studies of pharmacological interventions used as monotherapy; second-degree evidence=a similar design in the absence of a placebo or of a combination therapy as a comparative group; third-degree evidence=case reports, case series, and reviews of published studies. We found very few primary double-blind, placebo-controlled studies on the treatment of mixed states: the preponderance of available data derives from subgroup analysis performed on studies that originally involved manic patients. Future research should study the effects of treatments in mixed states defined using current criteria.
机译：双相情感障碍的混合状态被忽略了，并且关于治疗这些条件的数据相对模糊不清。为了解决这一点，我们系统地审查了情绪障碍中的“混合状态/发作”的已发表的药理治疗数据，包括DSM-5中的“混合特征”。我们搜索了PubMed，Medline，Cochrane图书馆，临床图书馆。 gov和contractvers.com（具有以下关键词的不同组合：“混合状态/特征，”双极，“”抑郁症状/双极抑郁“，”躁狂症状“，”治疗“，”DSM-5“ ）到2016年10月。我们应用了一种证据质量方法：一定程度的证据=随机安慰剂对药理学干预措施用作单一疗法的研究;二级证据=在没有安慰剂或组合疗法作为比较群体的类似设计;三学位证据=案例报告，案例系列，以及发表研究的评定。我们发现非常少数初级双盲，安慰剂对照研究对混合状态的治疗：可用数据的优势来自于最初涉及躁动患者的研究进行的亚组分析。未来的研究应研究治疗在使用当前标准定义的混合状态中的影响。

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