Mixed affective states in the juvenile age (historical aspects, current state of the problem, psychopathology)

The author analyzed the problem in historical, diagnostic and psychopathological aspects and presented the results of his own study. The aim was to study the structure and dynamics of endogenous juvenile mixed states in order to work out the psychopathological typology and to clarify the criteria of diagnosis, differential treatment and clinical-social prognosis. The study included 174 patients, 118 men and 56 women, aged from 17 to 25 years (mean age 20,4 years). Depressive states were found in 65%, mania in 16% and mixed in 19% of patients. The clinical differentiation of mixed states was carried out basing on the dominating pole of affective disorders and the following types were singled out and described: mania type (dysphoria-like mania) - 34%, depressive type (association-driven depression) - 38%; alternating type of mixed states - 28%. The preference of the formation of alternating and atypical variants of mixed states in the juvenile age demonstrated in the study may reflect the pathogenetic and pathoplastic effect of biological features characteristic of this age - lability and polymorphism of clinical presentations as well as immaturity of emotional and cognitive spheres.