Short history of mixed states

The notion of mixed states is classically associated with descriptions and categories inherited from Kraepelin. However, simultaneous descriptions of depressive and manic manifestations can be traced back to ancient times. Semiology and definitions of these clinical associations have evolved across the times. We provide here a short insight on four distinct periods: Greek authors from ancient times, pre-Kraepelinian psychiatry (18th and 19th centuries), Kraepelin's conceptualization, and contemporary psychiatry (20th and 21st centuries). All across these four eras, mixed states definition relied on two opposite perspectives. On the one hand, mixed states have been described as mere temporal associations of manic and depressive manifestations. On the other hand, mixed states have been defined as autonomous and stable entities. Such oppositions have their roots in the psychopathological discussions of the early 20th century, and are still debated in current international classifications. (C) L'Encephale, Paris, 2013. All rights reserved.