{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:52:22Z","timestamp":1788407542524,"version":"build-2803163510"},"reference-count":34,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Affective Disorders"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.jad.2025.120176","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T14:53:07Z","timestamp":1756565587000},"page":"120176","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["Prevalence and socio-clinical correlates of mixed features specifier in depressive episode: A cross-sectional study from North India"],"prefix":"10.1016","volume":"392","author":[{"given":"Rashika","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6325-644X","authenticated-orcid":false,"given":"Shivangi","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajeet","family":"Sidana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swarndeep","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jad.2025.120176_bb0005","doi-asserted-by":"crossref","DOI":"10.1097\/00004714-199604001-00002","article-title":"The prevalent clinical spectrum of bipolar disorders: beyond DSM-IV","volume":"16","author":"Akiskal","year":"1996","journal-title":"J. Clin. Psychopharmacol."},{"key":"10.1016\/j.jad.2025.120176_bb0010","first-page":"68","article-title":"Criteria for the \u201csoft\u201d bipolar spectrum: treatment implications","volume":"23","author":"Akiskal","year":"1987","journal-title":"Psychopharmacol. Bull."},{"key":"10.1016\/j.jad.2025.120176_bb0015","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0193-953X(05)70093-9","article-title":"The evolving bipolar spectrum: Prototypes I, II, III, IV","volume":"22","author":"Akiskal","year":"1999","journal-title":"Psychiatr. Clin. North Am."},{"key":"10.1016\/j.jad.2025.120176_bb0020","series-title":"Diagnostic and Statistical Manual of disorders, 5th edition","year":"2013"},{"key":"10.1016\/j.jad.2025.120176_bb0025","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1046\/j.1440-1819.2002.01051.x","article-title":"Depressive mixed state frequency: age\/gender effects","volume":"56","author":"Benazzi","year":"2002","journal-title":"Psychiatry. Clin. Neurosci."},{"key":"10.1016\/j.jad.2025.120176_bb0030","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000072792","article-title":"The role of gender in depressive mixed state","volume":"36","author":"Benazzi","year":"2003","journal-title":"Psychopathology"},{"key":"10.1016\/j.jad.2025.120176_bb0035","first-page":"20","article-title":"Exploring treatment strategies for mood stabilization in patients with major depressive disorder and mixed features","volume":"30","author":"Cuomo","year":"2024","journal-title":"J. Psychopathol."},{"key":"10.1016\/j.jad.2025.120176_bb0040","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jad.2020.09.117","article-title":"Psychometric properties of the clinically useful depression outcome scale supplemented with DSM-5 mixed subtype questionnaire in Chinese patients with mood disorders","volume":"279","author":"Du","year":"2021","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120176_bb0045","series-title":"Florida Best Practice Psychotherapeutic Medication Guidelines for Adults","year":"2023"},{"key":"10.1016\/j.jad.2025.120176_bb0050","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/jama.1989.03430110069030","article-title":"Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?","volume":"262","author":"Ford","year":"1989","journal-title":"JAMA"},{"key":"10.1016\/j.jad.2025.120176_bb0055","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1176\/appi.ajp.2008.08050746","article-title":"Manic symptoms during depressive episodes in 1,380 patients with bipolar disorder: findings from the STEP-BD","volume":"166","author":"Goldberg","year":"2009","journal-title":"Am. J. Psychiatry."},{"key":"10.1016\/j.jad.2025.120176_bb0060","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajp.2022.103439","article-title":"A comparative study of prevalence of mixed features in patients with unipolar and bipolar depression","volume":"81","author":"Grover","year":"2023","journal-title":"Asian. J. Psychiatr."},{"key":"10.1016\/j.jad.2025.120176_bb0065","series-title":"IBM SPSS statistics for windows, version 23.0. Armonk, NY","author":"IBM Corp","year":"2015"},{"key":"10.1016\/j.jad.2025.120176_bb0070","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: A systematic analysis for the global burden of disease study","volume":"392","author":"James","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.jad.2025.120176_bb0075","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0193-953X(05)70095-2","article-title":"Agitated depression as a mixed state and the problem of melancholia","volume":"22","author":"Koukopoulos","year":"1999","journal-title":"Psychiatr. Clin. North. Am."},{"key":"10.1016\/j.jad.2025.120176_bb0080","series-title":"Bipolar Disorders: Mixed States, Rapid Cycling and Atypical Forms","first-page":"157","article-title":"Agitated depression: spontaneous and induced","author":"Koukopoulos","year":"2005"},{"key":"10.1016\/j.jad.2025.120176_bb0085","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/j.jad.2020.08.080","article-title":"The koukopoulos mixed depression rating scale (KMDRS) and the assessment of mixed symptoms during the perinatal period","volume":"281","author":"Koukopoulos","year":"2021","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120176_bb0090","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1177\/07067437241245384","article-title":"Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 update on clinical guidelines for management of major depressive disorder in adults","volume":"69","author":"Lam","year":"2024","journal-title":"Can. J. Psychiatry."},{"key":"10.1016\/j.jad.2025.120176_bb0095","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.jad.2014.09.026","article-title":"The prevalence and illness characteristics of DSM-5-defined \u201cmixed feature specifier\u201d in adults with major depressive disorder and bipolar disorder: Results from the international mood disorders collaborative project","volume":"172","author":"McIntyre","year":"2015","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120176_bb0100","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2045125318762911","article-title":"Rethinking the spectrum of mood disorders: Implications for diagnosis and management","volume":"8","author":"McIntyre","year":"2018","journal-title":"Ther. Adv. Psychopharmacol."},{"key":"10.1016\/j.jad.2025.120176_bb0105","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1176\/appi.ajp.2016.15091119","article-title":"Mixed depression in bipolar disorder: Prevalence rate and clinical correlates during naturalistic follow-up in the Stanley Bipolar Network","volume":"173","author":"Miller","year":"2016","journal-title":"Am. J. Psychiatry."},{"key":"10.1016\/j.jad.2025.120176_bb0115","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1111\/bdi.13166","article-title":"Which mixed depression model? A comparison between DSM-5-defined mixed features and Koukopoulos\u2019 criteria","volume":"24","author":"Mineo","year":"2022","journal-title":"Bipolar Disord."},{"key":"10.1016\/j.jad.2025.120176_bb0120","first-page":"175","article-title":"Psychometric properties of the young mania rating scale as a mania severity measure in patients with bipolar I disorder","volume":"6","author":"Mohammadi","year":"2018","journal-title":"J. Pract. Clin. Psychol."},{"key":"10.1016\/j.jad.2025.120176_bb0125","first-page":"106","article-title":"Irritability associated with major depressive episodes: its relationship with mood disorders and temperament","volume":"25","author":"Parneix","year":"2014","journal-title":"Turk. Psikiyatri. Derg."},{"key":"10.1016\/j.jad.2025.120176_bb0130","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/bdi.12538","article-title":"Mixed state and suicide: Is the effect of mixed state on suicidal behavior more than the sum of its parts?","volume":"20","author":"Persons","year":"2018","journal-title":"Bipolar. Disord."},{"key":"10.1016\/j.jad.2025.120176_bb0135","doi-asserted-by":"crossref","first-page":"e351","DOI":"10.4088\/JCP.14m09092","article-title":"Mixed features in patients with a major depressive episode: The BRIDGE-II-MIX study","volume":"76","author":"Perugi","year":"2015","journal-title":"J. Clin. Psychiatry"},{"key":"10.1016\/j.jad.2025.120176_bb0140","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/acps.12686","article-title":"A systematic review and meta-analysis of prospective transition from major depression to bipolar disorder","volume":"135","author":"Ratheesh","year":"2017","journal-title":"Acta. Psychiatr. Scand."},{"key":"10.1016\/j.jad.2025.120176_bb0145","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1017\/S1092852916000432","article-title":"Treatment recommendations for DSM-5-defined mixed features","volume":"22","author":"Rosenblat","year":"2017","journal-title":"CNS Spectr."},{"key":"10.1016\/j.jad.2025.120176_bb0150","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S0193-953X(18)30748-2","article-title":"Atypical depression","volume":"7","author":"Silberman","year":"1984","journal-title":"Psychiatr. Clin. North. Am."},{"key":"10.1016\/j.jad.2025.120176_bb0155","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.pnpbp.2016.02.007","article-title":"Major depressive disorder with subthreshold hypomania (mixed features): clinical characteristics of patients entered in a multiregional, placebo-controlled study","volume":"68","author":"Targum","year":"2016","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry."},{"key":"10.1016\/j.jad.2025.120176_bb0160","first-page":"27","article-title":"Comparison of the emotion regulation and temperament characteristics between depressive patients with and without mixed features","volume":"57","author":"Tas","year":"2019","journal-title":"Noro Psikiyatr. Ars."},{"key":"10.1016\/j.jad.2025.120176_bb0165","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1093\/sleep\/28.11.1457","article-title":"Epidemiology of insomnia, depression, and anxiety","volume":"28","author":"Taylor","year":"2005","journal-title":"Sleep"},{"key":"10.1016\/j.jad.2025.120176_bb0170","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/acps.12911","article-title":"Characteristics of depressive and bipolar disorder patients with mixed features","volume":"138","author":"Tondo","year":"2018","journal-title":"Acta. Psychiatr. Scand."},{"key":"10.1016\/j.jad.2025.120176_bb0175","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s00406-018-0921-3","article-title":"Prevalence of seasonal depression in a prospective cohort study","volume":"269","author":"Wirz-Justice","year":"2019","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."}],"container-title":["Journal of Affective Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165032725016180?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165032725016180?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T05:07:16Z","timestamp":1780204036000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0165032725016180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":34,"alternative-id":["S0165032725016180"],"URL":"https:\/\/doi.org\/10.1016\/j.jad.2025.120176","relation":{},"ISSN":["0165-0327"],"issn-type":[{"value":"0165-0327","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prevalence and socio-clinical correlates of mixed features specifier in depressive episode: A cross-sectional study from North India","name":"articletitle","label":"Article Title"},{"value":"Journal of Affective Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jad.2025.120176","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"120176"}}