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This issue of Psychiatric Clinics, guest edited by Drs. Alan C. Swann and Gabriele Sani, is entitled Mixed Affective States: Beyond Current Boundaries. This issue is one of four each year selected by our series consulting editor, Dr. Harsh Trivedi of Sheppard Pratt Health System. Topics in this issue include: Clinical pictures of mixed states and its relation to temperament and personality; Psychopathology of mixed states; Unipolar agitated depression; Mixed features in mood disorders: the unmet needs of DSM-5; Trauma and mixed states; Suicidal acts and ideations in mixed states; Mixed states in early onset-bipolar disorder; Mixed states during the different phases of the reproductive cycle in women; Mixed states in patients with substance and behavioral addictions; Neurobiology of mixed states; Behavioral sensitization as a mechanism underlying and integrating mixed states; Pharmacological treatments of mixed states; ECT treatment of mixed states; and Innovative treatments including neuromodulation and psychotherapy.

1. Cover image - p. i 2. Title page - p. i 3. Table of Contents - p. i 4. Copyright - p. ii 5. Contributors - p. iii 6. Forthcoming Issues - p. xiv 7. Preface - p. xv 8. History and clinical impact: recognized and overlooked since (before) the beginning of psychiatry - p. xvii 9. Mixed States: Historical Impact and Evolution of the Concept - p. 1 10. Clinical characteristics and diagnostic challenges of mixed syndromes - p. 13 11. Clinical Picture, Temperament, and Personality of Patients with Mixed States - p. 15 12. Psychopathology of Mixed States - p. 27 13. Diagnosis, Clinical Features, and Implications of Agitated Depression - p. 47 14. Mixed Features in Depression: The Unmet Needs of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition - p. 59 15. Clinical contexts, complications, and challenges - p. 68 16. The Ring of Fire: Childhood Trauma, Emotional Reactivity, and Mixed States in Mood Disorders - p. 69 17. Suicidal Behavior Associated with Mixed Features in Major Mood Disorders - p. 83 18. Mixed States in Early-Onset Bipolar Disorder - p. 95 19. Perinatal Mixed Affective State: Wherefore Art Thou? - p. 113 20. Mixed States in Patients with Substance and Behavioral Addictions - p. 127 21. Mechanisms - p. 137 22. The Neurobiology of Mixed States - p. 139 23. Temporal Structure of Mixed States: Does Sensitization Link Life Course to Episodes? - p. 153 24. Treatment - p. 165 25. Pharmacologic Treatment of Mixed States - p. 167 26. The Role of Electroconvulsive Therapy in the Treatment of Severe Bipolar Mixed State - p. 187 27. Psychotherapy for Mixed Depression and Mixed Mania - p. 199

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This issue of Psychiatric Clinics, guest edited by Drs. Alan C. Swann and Gabriele Sani, is entitled Mixed Affective States: Beyond Current Boundaries. This issue is one of four each year selected by our series consulting editor, Dr. Harsh Trivedi of Sheppard Pratt Health System. Topics in this issue include: Clinical pictures of mixed states and its relation to temperament and personality; Psychopathology of mixed states; Unipolar agitated depression; Mixed features in mood disorders: the unmet needs of DSM-5; Trauma and mixed states; Suicidal acts and ideations in mixed states; Mixed states in early onset-bipolar disorder; Mixed states during the different phases of the reproductive cycle in women; Mixed states in patients with substance and behavioral addictions; Neurobiology of mixed states; Behavioral sensitization as a mechanism underlying and integrating mixed states; Pharmacological treatments of mixed states; ECT treatment of mixed states; and Innovative treatments including neuromodulation and psychotherapy.

1. Cover image - p. i 2. Title page - p. i 3. Table of Contents - p. i 4. Copyright - p. ii 5. Contributors - p. iii 6. Forthcoming Issues - p. xiv 7. Preface - p. xv 8. History and clinical impact: recognized and overlooked since (before) the beginning of psychiatry - p. xvii 9. Mixed States: Historical Impact and Evolution of the Concept - p. 1 10. Clinical characteristics and diagnostic challenges of mixed syndromes - p. 13 11. Clinical Picture, Temperament, and Personality of Patients with Mixed States - p. 15 12. Psychopathology of Mixed States - p. 27 13. Diagnosis, Clinical Features, and Implications of Agitated Depression - p. 47 14. Mixed Features in Depression: The Unmet Needs of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition - p. 59 15. Clinical contexts, complications, and challenges - p. 68 16. The Ring of Fire: Childhood Trauma, Emotional Reactivity, and Mixed States in Mood Disorders - p. 69 17. Suicidal Behavior Associated with Mixed Features in Major Mood Disorders - p. 83 18. Mixed States in Early-Onset Bipolar Disorder - p. 95 19. Perinatal Mixed Affective State: Wherefore Art Thou? - p. 113 20. Mixed States in Patients with Substance and Behavioral Addictions - p. 127 21. Mechanisms - p. 137 22. The Neurobiology of Mixed States - p. 139 23. Temporal Structure of Mixed States: Does Sensitization Link Life Course to Episodes? - p. 153 24. Treatment - p. 165 25. Pharmacologic Treatment of Mixed States - p. 167 26. The Role of Electroconvulsive Therapy in the Treatment of Severe Bipolar Mixed State - p. 187 27. Psychotherapy for Mixed Depression and Mixed Mania - p. 199

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