Clinical Neuropsychopharmacology and Therapeutics
Online ISSN : 1884-8826
ISSN-L : 1884-8826
Original Article
The 12-item self-rating questionnaire for depressive mixed state (DMX-12) in relation to categorical diagnoses of mixed depression and mixed features
Hotaka ShinzatoTsuyoshi Kondo
Author information

2019 Volume 10 Pages 18-25


Purpose: This study aimed to investigate the relationship of the newly developed 12-item dimensional scale of depressive mixed state (DMX-12) with categorical diagnoses of mixed depression (MD) defined by Benazzi in 2008 and mixed features (MF) as a specifier for depressive and bipolar disorders by DSM-5 in 2013.

Methods: The DMX-12 questionnaire was administered to 154 patients (57males and 97 females; 13-83 years) with major depressive episode (MDE) to quantify DMX symptoms. Receiver operating characteristic (ROC) curves were applied to examine the relationship between the DMX-12 and MD or MF.

Results: Among 154 patients, 28 cases (18.2%) showed MD while 7 cases (4.5%) showed MF. Selected 6 symptoms with AUC values more than 0.6 for ROC curves differentiating both MD and MF were overreactivity, inner tension, racing/crowded thought, impulsivity, dysphoria and risk-taking behavior. The AUC of ROC curve using the sum of these 6 symptoms scores was higher (.716 for MD and.761 for MF) than those using total score (.670 for MD and.704 for MF) and disruptive emotion/behavior subscale score (.684 for MD and.714 for MF) of the DMX-12. When the cut-off value in common for both MD and MF was set at ≥14, the sensitivity and negative predictive value for prediction of MD and MF were.750 and.920 for MD and.857 and.989 for MF, respectively.

Discussion: The selected 6 symptoms of the DMX-12 may be useful for sensitive screening and negative check of clinically relevant DMX with considerable severity in patients with MDE.

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© 2019 The Japanese Society of Clinical Neuropsychopharmacology
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