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Journal articles on the topic 'Mixed depression'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Benazzi, F., A. Koukopoulos, and H. S. Akiskal. "Toward a validation of a new definition of agitated depression as a bipolar mixed state (mixed depression)." European Psychiatry 19, no. 2 (2004): 85–90. http://dx.doi.org/10.1016/j.eurpsy.2003.09.008.

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AbstractPurposeAs psychotic agitated depression is now a well-described form of mixed state during the course of bipolar I disorder, we sought to investigate the diagnostic validity of a new definition for agitated (mixed) depression in bipolar II (BP-II) and major depressive disorder (MDD).Materials and methodsThree hundred and thirty six consecutive outpatients presenting with major depressive episodes (MDE) but without history of mania were evaluated with the Structured Clinical Interview for DSM-IV when presenting for the treatment of MDE. On the basis of history of hypomania they were ass

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Benazzi, Franco. "Reviewing the diagnostic validity and utility of mixed depression (depressive mixed states)." European Psychiatry 23, no. 1 (2008): 40–48. http://dx.doi.org/10.1016/j.eurpsy.2007.07.003.

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AbstractObjectiveTo review the diagnostic validity and utility of mixed depression, i.e. co-occurrence of depression and manic/hypomanic symptoms.MethodsPubMed search of all English-language papers published between January 1966 and December 2006 using and cross-listing key words: bipolar disorder, mixed states, criteria, utility, validation, gender, temperament, depression-mixed states, mixed depression, depressive mixed state/s, dysphoric hypomania, mixed hypomania, mixed/dysphoric mania, agitated depression, anxiety disorders, neuroimaging, pathophysiology, and genetics. A manual review of

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3

Benazzi, F. "P01.08 Depressive mixed state in atypical depression." European Psychiatry 15, S2 (2000): 322s. http://dx.doi.org/10.1016/s0924-9338(00)94419-5.

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Benazzi, Franco. "Defining mixed depression." Progress in Neuro-Psychopharmacology and Biological Psychiatry 32, no. 4 (2008): 932–39. http://dx.doi.org/10.1016/j.pnpbp.2007.12.019.

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Solé, Eva, Marina Garriga, Marc Valentí, and Eduard Vieta. "Mixed features in bipolar disorder." CNS Spectrums 22, no. 2 (2016): 134–40. http://dx.doi.org/10.1017/s1092852916000869.

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Mixed affective states, defined as the coexistence of depressive and manic symptoms, are complex presentations of manic-depressive illness that represent a challenge for clinicians at the levels of diagnosis, classification, and pharmacological treatment. The evidence shows that patients with bipolar disorder who have manic/hypomanic or depressive episodes with mixed features tend to have a more severe form of bipolar disorder along with a worse course of illness and higher rates of comorbid conditions than those with non-mixed presentations. In the updated Diagnostic and Statistical Manual of

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McElroy, Susan L., Anna I. Guerdjikova, and Francisco Romo-Nava. "Diagnosing and treating major depressive episodes that lie along the mood disorders spectrum: focus on depression with mixed features." CNS Spectrums 26, no. 2 (2021): 133–39. http://dx.doi.org/10.1017/s1092852921000262.

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AbstractGrowing evidence indicates that historical descriptions of mixed depression—broadly defined as major depressive episodes with subthreshold manic or hypomanic (hypo/manic) symptoms—are incredibly clinically relevant in this day-and-age. However, the first operational definition of mixed depression did not occur in the modern nomenclature until 2013 with publication of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and there has not been enough time to evaluate these criteria empirically. Thus, the most valid operational definition of a mixed depressive episo

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Fernandes, J. L., and J. C. Jorge. "P01-205-Standing in the shoulders of kraeplin's excited depression: evidences that suport “treating” depressive mixed state(s) as an official nosologic entity." European Psychiatry 26, S2 (2011): 206. http://dx.doi.org/10.1016/s0924-9338(11)71916-2.

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IntroductionKraepelin described in “manic-depressive insanity” (1899/1913) co-ocurrence of opposite polarity symptoms in mania, hypomania, and depression. A full opposite polarity syndrome was not required to diagnose mixed state(s). Actually, mixed state(s) in the official nosology - ICD-1o and DSM-IV - is essentially limited to fullblown mixed state(s) with concomitant syndromal mania and depression. Nevertheless in the past 35 years contributions of Akiskal, Benazzi, and others followed a time of opposition to Krapelin's concept of mixed states - on the part of proeminent psychiatrists, nam

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O’Brien, Brittany, Delphine Lee, Alan C. Swann, Sanjay J. Mathew, and Marijn Lijffijt. "Psychotherapy for Mixed Depression and Mixed Mania." Psychiatric Clinics of North America 43, no. 1 (2020): 199–211. http://dx.doi.org/10.1016/j.psc.2019.10.014.

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Bakish, David, Rami Habib, and Cynthia L. Hooper. "Mixed Anxiety and Depression." CNS Drugs 9, no. 4 (1998): 271–80. http://dx.doi.org/10.2165/00023210-199809040-00003.

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Pacchiarotti, Isabella, Giorgio D. Kotzalidis, Andrea Murru, et al. "Mixed Features in Depression." Psychiatric Clinics of North America 43, no. 1 (2020): 59–68. http://dx.doi.org/10.1016/j.psc.2019.10.006.

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11

Katon, Wayne, and Peter P. Roy-Byrne. "Mixed anxiety and depression." Journal of Abnormal Psychology 100, no. 3 (1991): 337–45. http://dx.doi.org/10.1037/0021-843x.100.3.337.

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12

Stahl, Stephen M., Debbi A. Morrissette, Gianni Faedda, et al. "Guidelines for the recognition and management of mixed depression." CNS Spectrums 22, no. 2 (2017): 203–19. http://dx.doi.org/10.1017/s1092852917000165.

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A significant minority of people presenting with a major depressive episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As this presentation may have important prognostic and treatment implications, the DSM–5 codified a new nosological entity, the “mixed features specifier,” referring to individuals meeting threshold criteria for an MDE and subthreshold symptoms of (hypo)mania or to individuals with syndromal mania and subthreshold depressive symptoms. The mixed features specifier adds to a growing list of monikers that have been put forward to describe phenotypes character

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13

Berk, Michael, Seetal Dodd, and Gin S. Malhi. "‘Bipolar Missed States’: The Diagnosis and Clinical Salience of Bipolar Mixed States." Australian & New Zealand Journal of Psychiatry 39, no. 4 (2005): 215–21. http://dx.doi.org/10.1080/j.1440-1614.2004.01557.x.

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Objective: To explore diagnostic and treatment issues concerning bipolar mixed states. Method: Bipolar mixed states are described and concerns about diagnostic and treatment difficulties are summarized and discussed. Result: Mixed states can present with equal admixtures of depressive or manic symptoms, or more commonly one component predominates. There is fair consensus, although little data, regarding the management of manic mixed states. However depressive mixed states are far more complex both in terms of recognition and management. People suffering from mixed states characteristically pre

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14

Koukopoulos, A., and G. Sani. "DSM-5 criteria for depression with mixed features: a farewell to mixed depression." Acta Psychiatrica Scandinavica 129, no. 1 (2013): 4–16. http://dx.doi.org/10.1111/acps.12140.

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15

Chang, Jae Seung, Yong Min Ahn, Han Young Yu, et al. "Exploring Clinical Characteristics of Bipolar Depression: Internal Structure of the Bipolar Depression Rating Scale." Australian & New Zealand Journal of Psychiatry 43, no. 9 (2009): 830–37. http://dx.doi.org/10.1080/00048670903107666.

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Objective: Due to its pleomorphic phenomenology, the clinical features of bipolar depression are difficult to assess. The objective of the present study was therefore to explore the internal structure of the Bipolar Depression Rating Scale (BDRS) in terms of the phenomenological characteristics of bipolar depression. Methods: Sixty patients with DSM-IV bipolar depression completed the BDRS, depression and excitement subscales of the Positive and Negative Syndrome Scale (PANSS-D and PANSS-E), 17-item Hamilton Depression Rating Scale, Montgomery–Äsberg Depression Rating Scale, Young Mania Rating

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Vollrath, M., and J. Angst. "Results of the Zurich Cohort Study: course of anxiety and depression." Psychiatry and Psychobiology 4, no. 5 (1989): 307–13. http://dx.doi.org/10.1017/s0767399x00000213.

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SummaryIn a longitudinal cohort study of young adults from the Canton of Zurich in Switzerland, the course of anxiety and depressive disorders was examined in 3 interviews over a period of 7 years. The 1-year prevalence rates of panic disorders (including a milder form), generalized anxiety disorder, major depression, and recurrent brief depression were similar from age 21–28 yr. Females prevailed among all diagnoses, their preponderance being strongest for mild panic and major depression. No differential course could be found for the 3 initial diagnostic groups in 1979: the pure anxiety disor

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17

Benazzi, Franco. "Mixed Depression, Suicidality, and Antidepressants." Journal of Clinical Psychiatry 67, no. 10 (2006): 1650–51. http://dx.doi.org/10.4088/jcp.v67n1024b.

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18

BENAZZI, FRANCO. "Mixed Depression and Rapid Cycling." American Journal of Psychiatry 165, no. 8 (2008): 1048. http://dx.doi.org/10.1176/appi.ajp.2008.08030357.

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Koukopoulos, A., G. Sani, A. E. Koukopoulos, G. Manfredi, I. Pacchiarotti, and P. Girardi. "Melancholia agitata and mixed depression." Acta Psychiatrica Scandinavica 115, s433 (2007): 50–57. http://dx.doi.org/10.1111/j.1600-0447.2007.00963.x.

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20

Raspopova, Natalya, Maria Dzhamantayeva, Yerbol Nurkatov, et al. "Modern approaches to the diagnosis and treatment of mixed anxiety-depressive disorders in primary health care." Journal "Medicine" 5-6, no. 215-216 (2021): 53–62. http://dx.doi.org/10.31082/1728-452x-2020-215-216-5-6-53-62.

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The relevance of this work is due to the wide prevalence of mixed anxiety-depressive disorders among general medical practice patients. At the present stage of development of the psychiatric service in the Republic of Kazakhstan, a new concept has been developed that assumes the transfer of a number of borderline mixed anxiety-depressive disorders to the competence of PHC doctors with the need for their treatment with modern antidepressants. The purpose of this work. Development and implementation in general clinical practice of modern methods of diagnosis and treatment of mixed anxiety-depres

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Liang, Raymond A., Raymond W. Lam, and Raymond J. Ancill. "ECT in the Treatment of Mixed Depression and Dementia." British Journal of Psychiatry 152, no. 2 (1988): 281–84. http://dx.doi.org/10.1192/bjp.152.2.281.

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Recent work has demonstrated the coexistence of depressive illness in some patients with dementing disorders. Two cases of mixed depression and dementia showed behavioural and mood improvement after treatment with ECT, but without improvement in cognition. The role of ECT in the treatment of affective symptoms in dementia is discussed.

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22

Lecrubier, Y., and E. Weiller. "Treatment of subsyndromal depression and mixed anxiety and depressive disorder." Biological Psychiatry 42, no. 1 (1997): 202S. http://dx.doi.org/10.1016/s0006-3223(97)87746-3.

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23

Benazzi, Franco. "Is depressive mixed state a transition between depression and hypomania?" European Archives of Psychiatry and Clinical Neuroscience 254, no. 2 (2004): 69–75. http://dx.doi.org/10.1007/s00406-004-0461-x.

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24

Drozdz, W., and A. Borkowska. "Depressive Mixed States: Symptomatology, Prevalence and Principles of Treatment." European Psychiatry 24, S1 (2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70808-9.

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Current diagnostic systems (DSM-IV-TR and ICD-10) do not include depressive mixed state (DMS) as a separate category. However, both historical descriptions and data from recent research clearly indicate that cooccurrence of (hypo)maniacal and depressive symptoms is standard in clinical picture of affective disorders. Most frequently employed criterion for DMS is the presence of at least three symptoms of (hypo)mania for 7 days during a major depressive episode. Not only formal diagnostic criteria for DMS are lacking but also psychometric assessment tools (for example the Hamilton Depression Sc

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25

Uher, R., O. Mantere, K. Suominen, and E. Isometsä. "Typology of clinical course in bipolar disorder based on 18-month naturalistic follow-up." Psychological Medicine 43, no. 4 (2012): 789–99. http://dx.doi.org/10.1017/s0033291712001523.

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BackgroundIndividual variation in the clinical course of bipolar disorder may have prognostic and therapeutic implications but is poorly reflected in current classifications. We aimed to establish a typology of the individual clinical trajectories based on detailed prospective medium-term follow-up.MethodLatent class analysis (LCA) of nine characteristics of clinical course (time depressed, severity of depression, stability of depression, time manic, severity of mania, stability of mania, mixed symptoms, mania-to-depression and depression-to-mania phase switching) derived from life charts pros

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McElroy, Susan L., and Paul E. Keck. "Dysphoric mania, mixed states, and mania with mixed features specifier: are we mixing things up?" CNS Spectrums 22, no. 2 (2016): 170–76. http://dx.doi.org/10.1017/s1092852916000717.

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Various terms have been used to describe mania when it is accompanied by depressive symptoms. In this article, we attempt to define and discuss 3 of these terms: dysphoric mania, mixed state, and mania with mixed features specifier. We conclude that whatever term is used, it is important to be aware that mania is more often unpleasant than pleasant, and that the unpleasantness is not limited to depression.

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27

Das-Munshi, Jayati, David Goldberg, Paul E. Bebbington, et al. "Public health significance of mixed anxiety and depression: beyond current classification." British Journal of Psychiatry 192, no. 3 (2008): 171–77. http://dx.doi.org/10.1192/bjp.bp.107.036707.

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BackgroundThe public health significance of mixed anxiety–depressive disorder (MADD) and the distinctiveness of its phenomenology have yet to be established.AimsTo determine the public health significance of MADD, and to compare its phenomenology with ICD-10 anxiety, depressive, and comorbid anxiety and depressive disorders.MethodWeighted analysis of data from the Great Britain National Psychiatric Morbidity survey was conducted with a representative household sample of 8580 persons aged 16–74 years.ResultsThe 1-month prevalence of MADD was 8.8%. A fifth of all days off work in Britain occurre

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Benazzi, Franco. "Irritability in depression can be a symptom of mixed depression." Acta Psychiatrica Scandinavica 121, no. 1 (2010): 80. http://dx.doi.org/10.1111/j.1600-0447.2009.01450.x.

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Shinzato, Hotaka, Yu Zamami, and Tsuyoshi Kondo. "The 12-Item Self-Rating Questionnaire for Depressive Mixed State (DMX-12) for Screening of Mixed Depression and Mixed Features." Brain Sciences 10, no. 10 (2020): 678. http://dx.doi.org/10.3390/brainsci10100678.

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For simultaneous screening of mixed features (MF) by DSM-5 and mixed depression (MD) by Benazzi, useful symptoms were extracted from our 12-item dimensional scale for depressive mixed state (DMX-12). Subjects were 190 consecutive cases with major depressive episode (MDE) who visited our clinic. Associations between symptomatological combinations of the DMX-12 and MF or MD were analyzed using receiver operating characteristic (ROC). The rate of MF was 4.2% while that of MD was 22.6%. Eight symptoms (overreactivity, inner tension, racing/crowded thought, impulsivity, irritability, aggression, ri

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Vieta, Eduard. "The treatment of mixed states and the risk of switching to depression." European Psychiatry 20, no. 2 (2005): 96–100. http://dx.doi.org/10.1016/j.eurpsy.2004.12.002.

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AbstractThere are few controlled studies evaluating the treatment of bipolar mixed states. Evidence suggests that mixed states may be more responsive to some anticonvulsants than to lithium. Olanzapine alone or in combination with divalproate or lithium has been adequately evaluated in randomized clinical trials involving mixed-state patients, whereas risperidone and quetiapine have not. There is also some evidence demonstrating the efficacy of ziprasidone and aripiprazole. The risk of switching to depression is high in mixed states. Conventional antipsychotics, such as haloperidol, may be les

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Sani, Gabriele, and Alan C. Swann. "Mixed States: Beyond Depression and Mania." Psychiatric Clinics of North America 43, no. 1 (2020): xv—xvii. http://dx.doi.org/10.1016/j.psc.2019.11.001.

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32

Benazzn, F. "P.1.002 Definitions of mixed depression." European Neuropsychopharmacology 14 (October 2004): S175—S176. http://dx.doi.org/10.1016/s0924-977x(04)80091-9.

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33

Berk, Michael, Seetal Dodd, and Gin S. Malhi. "Depression and Mania in Mixed States." American Journal of Psychiatry 163, no. 7 (2006): 1160. http://dx.doi.org/10.1176/ajp.2006.163.7.1160.

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Dobson, Keith S. "A Mixed Blessing in Understanding Depression." Contemporary Psychology 47, no. 6 (2002): 738–39. http://dx.doi.org/10.1037/001292.

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35

Pacchiarotti, Isabella, Lorenzo Mazzarini, Giorgio D. Kotzalidis, et al. "Mania and depression. Mixed, not stirred." Journal of Affective Disorders 133, no. 1-2 (2011): 105–13. http://dx.doi.org/10.1016/j.jad.2011.03.037.

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Balazs, J., F. Benazzi, Z. Rihmer, and H. S. Akiskal. "Mixed (bipolar) depression and suicide attempts." European Psychiatry 22 (March 2007): S249—S250. http://dx.doi.org/10.1016/j.eurpsy.2007.01.835.

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37

Rihmer, Zoltan, and Xenia Gonda. "Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour: The Role of Underlying Bipolarity." Depression Research and Treatment 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/906462.

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The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporary psychiatry. Based on the literature, this paper summarizes the author's view on antidepressant-resistant depression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypo)manic switches, mixed depressive episode, and antidepressant-associated suicidality among depressed patients are relatively most frequent in bipolar/bipolar spectrum depression and in children an

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Koukopoulos, Athanasios, Gabriele Sani, and S. Nassir Ghaemi. "Mixed features of depression: why DSM-5 is wrong (and so was DSM-IV)." British Journal of Psychiatry 203, no. 1 (2013): 3–5. http://dx.doi.org/10.1192/bjp.bp.112.124404.

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SummaryThe DSM system has never acknowledged a central position for mixed states; thus, mixed depressions have been almost completely neglected for decades. Now, DSM-5 is proposing diagnostic criteria for depression with mixed features that will lead to more misdiagnosis and inadequate treatment of this syndrome. Different criteria, based on empirically stronger evidence than exists for the DSM-5 criteria, should be adopted.

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AIRAKSINEN, E., M. LARSSON, I. LUNDBERG, and Y. FORSELL. "Cognitive functions in depressive disorders: evidence from a population-based study." Psychological Medicine 34, no. 1 (2004): 83–91. http://dx.doi.org/10.1017/s0033291703008559.

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Background. Most of the available evidence on the effects of depression is based on in- and out-patient samples focusing on individuals suffering from major depression. The aims of this study were to examine cognitive functioning in population-based samples and to determine whether cognitive performance varies as a function of depression subgroup.Method. Population-based samples (aged 20–64 years) with major depression (N=68), dysthymia (N=28), mixed anxiety-depressive disorder (N=25) and minor depression (N=66) were examined on a variety of cognitive tasks (i.e. episodic memory, verbal fluenc

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40

Akiskal, Hagop S., and Franco Benazzi. "Validating Kraepelin's two types of depressive mixed states: ‘depression with flight of ideas’ and ‘excited depression’." World Journal of Biological Psychiatry 5, no. 2 (2004): 107–13. http://dx.doi.org/10.1080/15622970410029919.

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Benazzi, Franco, and Hagop Akiskal. "Irritable-hostile depression: further validation as a bipolar depressive mixed state." Journal of Affective Disorders 84, no. 2-3 (2005): 197–207. http://dx.doi.org/10.1016/j.jad.2004.07.006.

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42

Leistner, Sarah M., Jens Klotsche, Christina Dimopoulou, et al. "Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas." European Journal of Endocrinology 172, no. 6 (2015): 733–43. http://dx.doi.org/10.1530/eje-14-0941.

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ObjectivesSeveral studies reported decreased quality of life (QoL) and sleep as well as increased rates of depression for patients with pituitary adenomas. Our aim was to explore to what extent differences in depression and sleep quality contribute to differences in QoL between patients with pituitary adenomas and controls.DesignA cross-sectional case–control study.SettingEndocrine Outpatient Unit of the Max Planck Institute of Psychiatry, Munich, Department of Internal Medicine, Ludwig-Maximilians-University, Munich, and the Institute of Clinical Psychology and Psychotherapy, Technical Univer

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43

Keck, Paul E., Mark A. Frye, and Michael E. Thase. "Bipolar Depression: Best Practices for the Hospitalized Patient." CNS Spectrums 12, S19 (2007): 4–11. http://dx.doi.org/10.1017/s1092852900015844.

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One of the most challenging clinical topics in psychiatry is the diagnosis and treatment of bipolar depression. The term mood stabilizer is frequently employed in the treatment of the hospitalized bipolar patient, although clinicians do not universally agree on a consensus definition of this term. Most clinicians would agree that a mood stabilizer refers to a medication that is effective for the acute treatment of manic, mixed, hypomanic, or depressive episodes. Many experts agree that such treatment should offer efficacy against mania, should not worsen depression, and preferably should treat

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44

Leite, F., H. Salgado, C. Olga, and P. Carvalho. "Recognition and treatment of bipolar mixed states." European Psychiatry 33, S1 (2016): S334—S335. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1170.

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IntroductionMixed features refers to the presence of high and low symptoms occurring at the same time, or as part of a single episode, in people experiencing an episode of mania or depression. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed features experiences symptoms of both mood “poles” – mania and depression – simultaneously or in rapid sequence.Aims and objectivesTo review the nosological status of bipolar mixed states and its treatment.MethodsOnline search/review of the literature has been carried out, using Medline/Pubmed

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45

Benazzi, Franco. "How to treat bipolar II depression and bipolar II mixed depression?" International Journal of Neuropsychopharmacology 7, no. 1 (2004): 105–6. http://dx.doi.org/10.1017/s146114570300395x.

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46

Hsin, Honor, and Trisha Suppes. "Psychopharmacology of Bipolar II Depression and Bipolar Depression with Mixed Features." FOCUS 12, no. 2 (2014): 136–45. http://dx.doi.org/10.1176/appi.focus.12.2.136.

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47

Tettamanti, Giorgio, Daniel Altman, Anastasia N. Iliadou, Rino Bellocco, and Nancy L. Pedersen. "Depression, Neuroticism, and Urinary Incontinence in Premenopausal Women: A Nationwide Twin Study." Twin Research and Human Genetics 16, no. 5 (2013): 977–84. http://dx.doi.org/10.1017/thg.2013.60.

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Previous studies have found that major depression and neuroticism are positively associated with urinary incontinence (UI). However, the genetic contribution to these associations has never been investigated. In 2005, a total of 14,094 female twins born 1959–1985 in the Swedish Twin Registry participated in a comprehensive survey on common exposures and complex diseases. Structured questions provided information on UI, depressive symptoms, major depression, and neuroticism. A logistic regression model based on generalized estimating equations (GEE) was used to estimate odds ratios (ORs) with 9

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48

Schneck, Christopher D. "Mixed Depression: The Importance of Rediscovering Subtypes of Mixed Mood States." American Journal of Psychiatry 166, no. 2 (2009): 127–30. http://dx.doi.org/10.1176/appi.ajp.2008.08111669.

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49

de la Fuente, JR. "Atypical depression: diagnosis and therapeutic issues." European Psychiatry 8, no. 5 (1993): 235–40. http://dx.doi.org/10.1017/s0924933800000286.

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SummaryA number of Meso-American artifacts which appear to depict subjects presenting severe depressive episodes have been identified, showing that concern with depressive disorders is not a recent phenomenon. Atypical presentations of depression in modern Mexico are characterized by a high degree of somatization, perhaps to avoid the stigma of “mental disorders”. Other characteristics are mood reactivity, substantial anxiety, phobias and the reversed vegetative manifestations. There is a high comorbidity with panic disorder and with bipolar depression. Nosological terminology is not fully sta

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Wolfson, Philip E. "Ketamine for Depression: A Mixed-Methods Study." International Journal of Transpersonal Studies 33, no. 2 (2014): 75–83. http://dx.doi.org/10.24972/ijts.2014.33.2.75.

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