It has recently been argued that a unidimensional approach to mood disorders, focusing predominantly on emotions is too narrow to capture the full spectrum of symptoms of affective disorders, and that additional symptom domains of activity and cognition are at least equally important – possibly even more so¹. This ‘ACE’ (Activity, Cognition and Emotion) model provides more clarity in conceptualising mixed states, the existence of which challenges the predominantly dichotomous view promulgated by DSM and ICD, in which mania and depression are deemed to be mutually exclusive and form two poles of mood disorders with little in between. However, in reality, there are symptoms that occur in both depression and mania, and to better understand mixed mood states it has been proposed that these ‘overlapping’ symptoms form the essence of mixed states, and therefore they should be central to their definition. Furthermore, within these, overlapping symptoms of distractibility, irritability and psychomotor agitation² are possibly the most important for better defining mixed states and advancing our understanding. Thus, in this brief article we endeavour to further refine our focus, specifically narrowing in on irritability, and argue that perhaps ‘it’ in particular holds the key to defining these complex presentations and unlocking their secrets.

中文翻译：

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易怒性能否成为解开混合国家之谜的关键？

最近有人争辩说，主要集中于情绪的一维方法来治疗情绪障碍太狭窄，不足以捕捉到情绪障碍的全部症状，而且活动和认知的其他症状域至少同样重要，甚至可能更重要。^1个。这种“ ACE”（活动，认知和情感）模型在混合状态的概念化方面提供了更多的清晰度，这种状态的存在挑战了DSM和ICD提出的主要二分法观点，其中躁狂症和抑郁症被认为是互斥的，形成了两个极点之间的情绪障碍很少。但是，实际上，在抑郁症和躁狂症中都会出现症状，为了更好地理解混合情绪状态，有人提出这些“重叠”症状构成了混合状态的本质，因此，它们对于它们的定义应该是中心的。此外，在这些症状中，分心，烦躁和精神运动性躁动的重叠症状²对于更好地定义混合状态和增进我们的理解可能是最重要的。因此，在这篇简短的文章中，我们将努力进一步完善我们的关注点，特别是缩小易怒性，并认为也许“它”尤其是定义这些复杂演示文稿并释放其秘密的关键。