November 1974

Depression, Elation, and Lithium Carbonate Responses in Manic Patient Subgroups

Author Affiliations

From the Laboratory of Clinical Science, National Institute of Mental Health, NIH Clinical Center, Bethesda, Md. Dr. Beigel is now with the Department of Psychiatry, University of Arizona College of Medicine, Tucson.

Arch Gen Psychiatry. 1974;31(5):643-648. doi:10.1001/archpsyc.1974.01760170043007

Depressive elements were observed on a quantitative behavioral rating scale during manic episodes in 28 of 30 patients, suggesting that most manic patients manifest a "mixed" manic-depressive picture. A factor analysis of the scale confirmed a "core" group of manic symptoms as well as a dichotomous grouping of elated-grandiose (E-G) and paranoid-destructive (P-D) patients. It also suggested a close relationship between the presence of rated depression during mania and the particular symptomatic complex found in the P-D subgroup of manic patients.

Elation ratings were not significantly correlated with total mania scale ratings in all, but only in the subgroup of E-G patients. These differences had apparent relationships to therapeutic responses to lithium carbonate; manic patients in the E-G subgroup responded more frequently than did patients in the P-D subgroup.