Depression with Mixed Features in Adolescent Psychiatric Patients

Depression with mixed features is poorly understood, especially in pediatric samples. This study compares symptoms and correlates of depressed adolescent inpatients with mixed features to inpatients with bipolar disorder and major depression. 407 adolescents were administered diagnostic interviews and self-reports, and 262 were categorized as Depression with Mixed Features (MXD; n = 38), Consensus Bipolar (CB; n = 79), or Depression Only (DO; n = 145). Demographic and morbidity information were collected via chart reviews. MXD adolescents evidenced elevated mania-related symptoms compared to DO adolescents. MXD adolescents had elevated Unusually Energetic symptoms and increases for six additional category B mania-related symptoms compared to CB adolescents. MXD adolescents met criteria for more comorbid disorders and reported elevated suicidality, anger, and trauma symptoms compared to CB and DO adolescents. Overall, MXD adolescents evidenced elevated symptomatology compared to other groups, suggesting mixed depression may represent a unique constellation of symptoms meriting further investigation.