Agitated depression as a mixed state and the problem of melancholia

After a review of the literature on melancholia agitata and on the concept and clinical forms of mixed states, the psychopathology of agitated depression is discussed. Clinical forms are described, and new diagnostic criteria are proposed. Recognizing the mixed nature of agitated depression is crucial because many patients who have adverse reactions to antidepressants suffer from this syndrome. The term mixed depression is proposed for all forms of agitated depression.