The State of the Art of the DSM-5 “with Mixed Features” Specifier

The new DSM-5 “with mixed features” specifier (MFS) has renewed the interest of the scientific community in mixed states, leading not only to new clinical studies but also to new criticisms of the current nosology. Consequently, in our paper we have reviewed the latest literature, trying to understa...

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Bibliographic Details
Published in:TheScientificWorld 2015, Vol.2015 (2015), p.1-7
Main Authors: Piselli, Massimiliano, Quartesan, Roberto, Moretti, Patrizia, Verdolini, Norma, Agius, Mark, Ferranti, Laura
Format: Article
Language:English
Subjects:
Affective disorders
Behavioral assessment
Bipolar disorder
Bipolar Disorder - diagnosis
Bipolar Disorder - physiopathology
Bipolar Disorder - psychology
Classification
Clinical psychology
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - physiopathology
Depressive Disorder, Major - psychology
Diagnosis
Diagnostic and Statistical Manual of Mental Disorders
Epidemiology
Humans
Illnesses
Irritable Mood
Methods
Psychiatric Status Rating Scales
Psychomotor Agitation - physiopathology
Psychotropic drugs
Review
Studies
Terminology as Topic
Validity
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Summary:The new DSM-5 “with mixed features” specifier (MFS) has renewed the interest of the scientific community in mixed states, leading not only to new clinical studies but also to new criticisms of the current nosology. Consequently, in our paper we have reviewed the latest literature, trying to understand the reactions of psychiatrists to the new nosology and its epidemiological, prognostic, and clinical consequences. It seems that the most widespread major criticism is the exclusion from the DSM-5 MFS of overlapping symptoms (such as psychomotor agitation, irritability, and distractibility), with a consequent reduction in diagnostic power. On the other hand, undoubtedly the new DSM-5 classification has helped to identify more patients suffering from a mixed state by broadening the narrow DSM-IV-TR criteria. As for the clinical presentation, the epidemiological data, and the therapeutic outcomes, the latest literature does not point out a univocal point of view and further research is needed to fully assess the implications of the new DSM-5 MFS. It is our view that a diagnostic category should be preferred to a specifier and mixed states should be better considered as a spectrum of states, according to what was stated many years ago by Kraepelin.
ISSN:2356-6140
1537-744X
1537-744X
DOI:10.1155/2015/757258