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1 results

  • Chronic mania: Family history, prior course, clinical picture and social consequences

  • Giulio Perugi, Hagop S. Akiskal, Luciano Rossi, Antonic Paiano, Cinzia Quilici, Donato Madaro, Laura Musetti, Giovanni B. Cassano
  • Journal:
    The British Journal of Psychiatry / Volume 173 / Issue 6 / December 1998
    Published online by Cambridge University Press:
    03 January 2018, pp. 514-518
    Print publication:
    December 1998
  • 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.