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Chronic mania

Family history, prior course, clinical picture and social consequences

Published online by Cambridge University Press:  03 January 2018

Giulio Perugi ,
Hagop S. Akiskal ,
Luciano Rossi ,
Antonic Paiano ,
Cinzia Quilici ,
Donato Madaro ,
Laura Musetti  and
Giovanni B. Cassano
Giulio Perugi*
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
Hagop S. Akiskal
Affiliation:
Department of Psychiatry, University of California, San Diego, USA
Luciano Rossi
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
Antonic Paiano
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
Cinzia Quilici
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
Donato Madaro
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
Laura Musetti
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
Giovanni B. Cassano
Affiliation:
Institute of Psychiatry, University of Pisa, Italy
*
Dr G. Perugi, Institute of Psychiatry, Via Roma 67, 56100, Pisa. Italy. Tel. 39-50-835414; Fax. 39-50-21581
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Abstract

Background

Mania with chronic course has been overlooked in the recent literature. Our aim was clinically to characterise and validate this form of mania.

Method

We evaluated 155 people with DSM–III–R mania and assessed their family history, temperament, symptomatology and course. We used a semi-structured interview for mood disorders, as well as the Comprehensive Psychopathological Rating Scale and the Scale for the Assessment of Positive Symptoms.

Results

Twenty (13%) had a chronic course arising from a background of hyperthymic temperament and recurrent mania, with a deteriorative pattern. Clinically, they were characterised by a significantly high rate of almost constant euphoria, grandiose delusions and related delusions, but had relatively low rates of sleep disturbance, psychomotor agitation and hypersexuality.

Conclusion

Even with current therapies a significant number of people with bipolar disorders have a deteriorative outcome associated with the gradual disappearance of acute mania with an increase in mregalomanic delusions, alienation from loved ones and decreased likelihood of medical and psychiatric care.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 6 , December 1998 , pp. 514 - 518
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

Akiskal, H. S. & Cassano, G. B. (1997) Dysthymia and the Spectrum of Chronic Depressions. New York: Guilford Press.Google Scholar
Akiskal, H. S., Khani, M. K. & Scott-Strauss, A. (1979) Cyclothymic temperamental disorders. Psychiatric Clinics of North America, 2, 527–554.CrossRefGoogle Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: American Psychiatric Association.Google Scholar
Andreasen, N. C. (1984) Scale for the Assessment of Positive Symptoms (SAPS). Iowa City, IA: University of Iowa.Google Scholar
Andreasen, N. C., Endicott, J., Spitzer, R. L., et al (1977) The family history method using diagnostic criteria. Reliability and validity. Archives of General Psychiatry, 34, 1229–1235.Google Scholar
Asberg, M., Montgomery, S. A., Ferris, C., et al (1978) A comprehensive Psychopathological rating scale. Acta Psychiatrica Scandinavica, 153 (suppl. 271), 5–27.Google Scholar
Cassano, G. B., Akiskal, H. S., Musetti, L., et al (1989) Psychopathology, temperament, and past course in primary major depressions. 2. Toward a redefinition of bipolarity with a new semistructured interview for depression. Psychopathology, 22, 278–288.Google Scholar
Clouston, T. S. (1892) Clinical Lectures on Mental Diseases (3rd edn). London: Churchill.Google Scholar
Deron, R. (1928) Le Syndrome Maniaque. Paris: Doin.Google Scholar
Hare, E. (1981) The two manias: a study of the evolution of the modern concept of mania. British Journal of Psychiatry, 138, 89–99.CrossRefGoogle Scholar
Musetti, L., Perugi, G., Soriani, A., et al (1989) Depression before and after age 65. A re-examination. British Journal of Psychiatry, 155, 330–336.Google Scholar
Perugi, G., Musetti, L., Simonini, E., et al (1990) Gender-mediated clinical features of depressive illness: the importance of temperamental differences. British Journal of Psychiatry, 157, 835–841.Google Scholar
Schneider, K. (1959) Clinical Psychopathology New York: Grune and Stratton.Google Scholar
Vocisano, C., Klein, D. N., Keefe, R. S. E., et al (1996) Demographics, family history, premorbid functioning, developmental characteristics, and course of patients with deteriorated affective disorder. American Journal of Psychiatry, 15, 248–255.Google Scholar
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