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I. DSM-IV Diagnostic Criteria A. Patient meets criteria for both for at least one week. B. Symptoms are severe enough to cause marked impairment in occupational or social functioning, require hospitalization, or psychotic features are present. C. Organic factors have been excluded (medical conditions, medications, drugs). II. Clinical Features of Mixed Mood Episodes A. Patients subjectively experience rapidly shifting moods. B. They frequently present with agitation, psychosis, suicidality, appetite disturbance and insomnia