{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:57:40Z","timestamp":1794362260424,"version":"4.9.0"},"reference-count":59,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2004,7,1]],"date-time":"2004-07-01T00:00:00Z","timestamp":1088640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychiatry Research"],"published-print":{"date-parts":[[2004,7]]},"DOI":"10.1016\/j.psychres.2003.07.006","type":"journal-article","created":{"date-parts":[[2004,7,22]],"date-time":"2004-07-22T19:46:18Z","timestamp":1090525578000},"page":"247-257","source":"Crossref","is-referenced-by-count":23,"title":["Mixed states in bipolar II disorder: should full hypomania always be required?"],"prefix":"10.1016","volume":"127","author":[{"given":"Franco","family":"Benazzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.psychres.2003.07.006_BIB8","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1176\/ajp.134.11.1227","article-title":"Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group","volume":"134","author":"Akiskal","year":"1977","journal-title":"American Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB7","first-page":"68","article-title":"Criteria for the \u2018soft\u2019 bipolar spectrum: treatment implications","volume":"23","author":"Akiskal","year":"1987","journal-title":"Psychopharmacology Bulletin"},{"issue":"suppl 1","key":"10.1016\/j.psychres.2003.07.006_BIB6","doi-asserted-by":"crossref","first-page":"4S","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":"Journal of Clinical Psychopharmacology"},{"key":"10.1016\/j.psychres.2003.07.006_BIB5","doi-asserted-by":"crossref","unstructured":"Akiskal, H.S. and Pinto, O., 1999. The evolving bipolar spectrum: prototypes I, II, III, and IV. In: Akiskal, H.S. (Ed.), Bipolarity: beyond classic mania. Psychiatric Clinics of North America 22, 517\u2013534","DOI":"10.1016\/S0193-953X(05)70093-9"},{"issue":"suppl 1","key":"10.1016\/j.psychres.2003.07.006_BIB4","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/S0165-0327(00)00203-2","article-title":"Re-evaluating the prevalence and diagnostic composition within the broad clinical spectrum of bipolar disorders","volume":"59","author":"Akiskal","year":"2000","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB3","series-title":"Bipolar disorder","first-page":"1","article-title":"Classification, diagnosis and boundaries of bipolar disorders: a review","author":"Akiskal","year":"2002"},{"key":"10.1016\/j.psychres.2003.07.006_BIB2","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S0165-0327(02)00330-0","article-title":"Family history validation of the bipolar nature of depressive mixed states","volume":"73","author":"Akiskal","year":"2003","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0165-0327(02)00390-7","article-title":"Validating \u2018hard\u2019 and \u2018soft\u2019 phenotypes within the bipolar spectrum: continuity or discontinuity?","volume":"73","author":"Akiskal","year":"2003","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB9","unstructured":"American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). American Psychiatric Association, Washington, DC"},{"key":"10.1016\/j.psychres.2003.07.006_BIB10","unstructured":"American Psychiatric Association, 1994. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association, Washington, DC"},{"issue":"suppl 30","key":"10.1016\/j.psychres.2003.07.006_BIB12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1192\/S0007125000298383","article-title":"Comorbidity of mood disorders: a longitudinal prospective study","volume":"168","author":"Angst","year":"1996","journal-title":"British Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB11","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0165-0327(98)00142-6","article-title":"The emerging epidemiology of hypomania and bipolar II disorder","volume":"50","author":"Angst","year":"1998","journal-title":"Journal of Affective Disorders"},{"issue":"suppl 1","key":"10.1016\/j.psychres.2003.07.006_BIB13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1034\/j.1399-5618.4.s1.1.x","article-title":"A new bipolar spectrum concept: a brief review","volume":"4","author":"Angst","year":"2002","journal-title":"Bipolar Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB14","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0165-0327(02)00322-1","article-title":"Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania","volume":"73","author":"Angst","year":"2003","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB26","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/S0165-0327(96)01421-8","article-title":"Prevalence of bipolar II disorder in outpatient depression: a 203-case study in private practice","volume":"43","author":"Benazzi","year":"1997","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB25","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1080\/j.1440-1614.2000.0751d.x","article-title":"Age as substitute of age at onset in mood disorder studies","volume":"34","author":"Benazzi","year":"2000","journal-title":"Australian and New Zealand Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB24","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/S0010-440X(00)90142-1","article-title":"Borderline personality disorder and bipolar II disorder in private practice depressed outpatients","volume":"41","author":"Benazzi","year":"2000","journal-title":"Comprehensive Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB23","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1046\/j.1440-1819.2001.00919.x","article-title":"Depressive mixed state: testing different definitions","volume":"55","author":"Benazzi","year":"2001","journal-title":"Psychiatry and Clinical Neuroscience"},{"key":"10.1016\/j.psychres.2003.07.006_BIB22","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s004060170065","article-title":"Is 4 days the minimum duration of hypomania in bipolar II disorder?","volume":"251","author":"Benazzi","year":"2001","journal-title":"European Archives of Psychiatry and Clinical Neuroscience"},{"key":"10.1016\/j.psychres.2003.07.006_BIB21","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0165-0327(99)00038-5","article-title":"Bipolar II depression in late life: prevalence and clinical features in 525 depressed outpatients","volume":"66","author":"Benazzi","year":"2001","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB20","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1053\/comp.2001.27901","article-title":"Sensitivity and specificity of clinical markers for the diagnosis of bipolar II disorder","volume":"42","author":"Benazzi","year":"2001","journal-title":"Comprehensive Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB19","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S0165-0327(01)00444-X","article-title":"Delineating bipolar II mixed states in the Ravenna-San Diego collaborative study: the relative prevalence and diagnostic significance of hypomanic features during major depressive episodes","volume":"67","author":"Benazzi","year":"2001","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB18","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3109\/10401230209149096","article-title":"Agitated depression: unipolar? Bipolar? Or both?","volume":"14","author":"Benazzi","year":"2002","journal-title":"Annals of Clinical Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB17","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/S0278-5846(02)00244-0","article-title":"Which could be a clinically useful definition of depressive mixed state?","volume":"26","author":"Benazzi","year":"2002","journal-title":"Progress in Neuro-Psychopharmacology and Biological Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB16","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0165-0327(02)00327-0","article-title":"Refining the evaluation of bipolar II: beyond the strict SCID-CV guidelines for hypomania","volume":"73","author":"Benazzi","year":"2003","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB15","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1053\/comp.2003.50000","article-title":"Bipolar II depressive mixed state: finding a useful definition","volume":"44","author":"Benazzi","year":"2003","journal-title":"Comprehensive Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB27","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1017\/S0033291701004184","article-title":"A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN)","volume":"31","author":"Brugha","year":"2001","journal-title":"Psychological Medicine"},{"key":"10.1016\/j.psychres.2003.07.006_BIB28","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/0165-0327(92)90044-7","article-title":"Proposed subtypes of bipolar II and related disorders: with hypomanic episodes (or cyclothymia) and with hyperthymic temperament","volume":"26","author":"Cassano","year":"1992","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB29","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1176\/ajp.152.3.385","article-title":"Long-term stability of polarity distinctions in the affective disorders","volume":"152","author":"Coryell","year":"1995","journal-title":"American Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB30","series-title":"Bipolar disorders. Clinical course and outcome","first-page":"219","article-title":"Bipolar II disorder: the importance of hypomania","author":"Coryell","year":"1999"},{"key":"10.1016\/j.psychres.2003.07.006_BIB31","series-title":"Mania. Clinical and research perspectives","first-page":"3","article-title":"Diagnostic revisions for DSM-IV","author":"Dunner","year":"1998"},{"key":"10.1016\/j.psychres.2003.07.006_BIB32","first-page":"303","article-title":"Diagnostic reliability of the history of hypomania in bipolar II patients and patients with major depression. Comprehensive","volume":"34","author":"Dunner","year":"1993","journal-title":"Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB33","series-title":"Structured clinical interview for DSM-IV axis I disorders-clinician version (SCID-CV)","author":"First","year":"1997"},{"key":"10.1016\/j.psychres.2003.07.006_BIB34","doi-asserted-by":"crossref","first-page":"735","DOI":"10.4088\/JCP.v62n0912c","article-title":"Dr. Ghaemi replies. High prevalence of bipolar spectrum disorders, by Benazzi F","volume":"62","author":"Ghaemi","year":"2001","journal-title":"Journal of Clinical Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB35","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/070674370204700202","article-title":"Cade's disease\u2019 and beyond: misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder","volume":"47","author":"Ghaemi","year":"2002","journal-title":"Canadian Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB36","series-title":"Bipolar disorders. Clinical course and outcome","first-page":"129","article-title":"Depression in the course of bipolar disorder","author":"Goldberg","year":"1999"},{"key":"10.1016\/j.psychres.2003.07.006_BIB37","series-title":"Manic-depressive illness","author":"Goodwin","year":"1990"},{"key":"10.1016\/j.psychres.2003.07.006_BIB38","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/S0165-0327(98)00112-8","article-title":"Systematic clinical methodology for validating bipolar-II disorder: data in mid-stream from a french national multi-site study (EPIDEP)","volume":"50","author":"Hantouche","year":"1998","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB39","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1001\/archpsyc.60.3.261","article-title":"A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder","volume":"60","author":"Judd","year":"2003","journal-title":"Archives of General Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB40","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1001\/archpsyc.1982.04290110084014","article-title":"The choice of diagnostic criteria for biological research","volume":"39","author":"Kendell","year":"1982","journal-title":"Archives of General Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB41","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1176\/appi.ajp.160.1.4","article-title":"Distinguishing between the validity and utility of psychiatric diagnoses","volume":"160","author":"Kendell","year":"2003","journal-title":"American Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB42","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1001\/archpsyc.1980.01780190097012","article-title":"The nosologic validity of paranoia (simple delusional disorder)","volume":"37","author":"Kendler","year":"1980","journal-title":"Archives of General Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB43","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1001\/archpsyc.1990.01810220085011","article-title":"Toward a scientific psychiatric nosology. Strengths and limitations","volume":"47","author":"Kendler","year":"1990","journal-title":"Archives of General Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB44","first-page":"547","article-title":"Agitated depression as a mixed state and the problem of melancholia","volume":"22","author":"Koukopoulos","year":"1999"},{"key":"10.1016\/j.psychres.2003.07.006_BIB45","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4088\/JCP.v63n0206","article-title":"Demographic and clinical characteristics of individuals in a bipolar disorder case registry","volume":"63","author":"Kupfer","year":"2002","journal-title":"Journal of Clinical Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB46","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/S0010-440X(97)90089-4","article-title":"On the nature of depressive and anxious states in a family practice setting: the high prevalence of bipolar II and related disorders in a cohort followed longitudinally","volume":"38","author":"Manning","year":"1997","journal-title":"Comprehensive Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB47","series-title":"Bipolar Disorders: 100 years after manic-depressive insanity","first-page":"1","article-title":"Bipolar disorders: roots and evolution","author":"Marneros","year":"2000"},{"key":"10.1016\/j.psychres.2003.07.006_BIB48","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1176\/ajp.151.2.210","article-title":"Influence of clinical subtype, sex, and lineality on age at onset of major affective disorder in a family sample","volume":"151","author":"McMahon","year":"1994","journal-title":"American Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB49","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0165-0327(01)00443-8","article-title":"Clinical characterization of depressive mixed state in bipolar-I patients: Pisa-San Diego collaboration","volume":"67","author":"Perugi","year":"2001","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB50","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0165-0327(97)01446-8","article-title":"Clinical subtypes of bipolar mixed states: validating a broader european definition in 143 cases","volume":"43","author":"Perugi","year":"1997","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB51","doi-asserted-by":"crossref","first-page":"s169","DOI":"10.1192\/bjp.178.41.s169","article-title":"The Stanley Foundation Bipolar Network. 1. Rationale and methods","volume":"178","author":"Post","year":"2001","journal-title":"British Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB52","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1176\/ajp.126.7.983","article-title":"Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia","volume":"126","author":"Robins","year":"1970","journal-title":"American Journal of Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB53","first-page":"8","article-title":"Exploring the shape of univariate data using Kernel density estimators","volume":"16","author":"Salgado-Ugarte","year":"1994","journal-title":"STATA Technical Bulletin"},{"key":"10.1016\/j.psychres.2003.07.006_BIB54","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1034\/j.1600-0447.2003.00051.x","article-title":"Frequency of manic symptoms during a depressive episode and unipolar \u2018depressive mixed state\u2019 as bipolar spectrum","volume":"107","author":"Sato","year":"2003","journal-title":"Acta Psychiatrica Scandinavica"},{"key":"10.1016\/j.psychres.2003.07.006_BIB55","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1001\/archpsyc.59.8.736","article-title":"Diagnostic reliability of bipolar II diagnosis","volume":"59","author":"Simpson","year":"2002","journal-title":"Archives of General Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB56","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0165-0327(01)00432-3","article-title":"The Stanley foundation bipolar treatment outcome network II. Demographics and illness characteristics of the first 261 patients","volume":"67","author":"Suppes","year":"2001","journal-title":"Journal of Affective Disorders"},{"key":"10.1016\/j.psychres.2003.07.006_BIB57","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1001\/archpsyc.57.7.675","article-title":"Brief screening for family psychiatric history. The family history screen","volume":"57","author":"Weissman","year":"2000","journal-title":"Archives of General Psychiatry"},{"key":"10.1016\/j.psychres.2003.07.006_BIB58","unstructured":"Williams, J.B.W., Terman, M., Link, M.J., Amira, L., Rosenthal, N.E., 1994 (rev 2000). Hypomania interview guide (including hyperthymia). Current assessment version (HIGH-C). Clinical Assessment Tools Packet, Center for Environmental Therapeutics, Norwood, NJ"},{"key":"10.1016\/j.psychres.2003.07.006_BIB59","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1002\/(SICI)1520-6394(1999)9:2<92::AID-DA8>3.0.CO;2-1","article-title":"Hypomania interview guide (including hyperthymia): Retrospective assessment version (HIGH-R)","volume":"9","author":"Williams","year":"1999","journal-title":"Depression and Anxiety"}],"container-title":["Psychiatry Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S016517810400109X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S016517810400109X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T20:47:32Z","timestamp":1585860452000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S016517810400109X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,7]]},"references-count":59,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2004,7]]}},"alternative-id":["S016517810400109X"],"URL":"https:\/\/doi.org\/10.1016\/j.psychres.2003.07.006","relation":{},"ISSN":["0165-1781"],"issn-type":[{"value":"0165-1781","type":"print"}],"subject":[],"published":{"date-parts":[[2004,7]]}}}