INTRODUCTION
manic, bipolar I depression, sleep disturbance, hypomanic, bipolar disorder, depressive, bipolar depression, Montgomery-Asberg Depression, depression
The co-occurrence of depressive and manic symptoms in the same mood episode presents significant challenges for the diagnosis and treatment of people with bipolar disorder. The presence of subthreshold hypomanic symptoms in pediatric bipolar depression may be associated with significant impairment in functioning, and can complicate the illness course and treatment outcome [Mechanisms underlying mixed symptom presentations are complex. The clinical presentations of depression with manic or hypomanic symptoms are highly heterogeneous [A symptom network can be represented by a collection of nodes (symptoms) and edges (lines linking between symptoms) [Lurasidone is a second-generation antipsychotic agent with a high affinity for DA recent network analysis involving adults with subthreshold manic symptoms accompanying a major depressive episode showed sleep disturbance that overlapped and bridged between the depressive and manic symptom clusters at study baseline predicted overall treatment outcomes, as assessed by change from baseline in Montgomery-Asberg Depression Rating Scale (MADRS) [The objectives of this post-hoc analysis were to investigate “bridge” symptoms (overlapping symptoms that have cross-sectional and predictive associations with depressive and manic symptom clusters) in children and adolescents with bipolar I depression and to evaluate their effects on the treatment outcomes of lurasidone 20-80 mg/d in a 6-week, placebo-controlled, double-blind study [