Diagnosis and Treatment of Bipolar Disorder Mixed State with Integration of Traditional Chinese Medicine and Western Medicine: Expert Consensus of Zhejiang Province in China.

Background • As a mixed state of depressive and manic syndrome, the concept of bipolar disorder has remained unclear to date. Treatment of mixed states is difficult due to clinical recognition and poor therapeutic ideas. Based on expert consensus, it is important to establish a new definition of bipolar disorder, understand the concept of its mixed state within the field of clinical psychiatry, and explore its diagnosis and treatment using Traditional Chinese Medicine and Western medicine Methods • The Chinese Biomedical Database, China National Knowledge Infrastructure, WANFANG Database, Chinese Social Sciences Citation Index, and PubMed were used to retrieve relevant studies according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The retrieved studies were analyzed through the lens of evidence-based medicine, and the primary conclusion was obtained after quality control of 11 items listed in the Agency for Healthcare Research and Quality (AHRQ). An expert consultation, evaluation of conflict of interest, and the Appraisal of Guidelines for Research & Evaluation II (AGREE II) assessment were completed one after another. The expert consensus was established. Results • It was defined in expert consensus that bipolar disorder mixed state includes three aspects: mixed episode in ICD-10/11, mixed feature in DSM-5, and mixed unit in Tongde criteria. The syndrome and its therapeutic methods of bipolar disorder mixed state were classified and described in the Traditional Chinese Medicine approach, which was combined with Western medicine for diagnosis and therapeutics. Conclusion • The expert consensus of integrating Traditional Chinese Medicine and Western medicine for diagnosing and treating bipolar disorder with mixed states has been established, to help clinical practice. [ABSTRACT FROM AUTHOR]