• Fifty-six patients with mania and psychotic features and 14 with schizoaffective disorder, manic type, were followed up with biannual assessments during a 5-year period. Results were treated as they were in an analogous follow-up of patients with psychotic major depression or schizoaffective disorder, depressed type. Patients with schizoaffective mania experienced more morbidity during follow-up than did patients with psychotic mania. Among patients with schizoaffective mania, those with a chronic subtype did far worse than did the others, while the mainly schizophrenic-mainly affective distinction was not predictive. When depressed and manic groups were combined (n =173), the following baseline variables were significant independent predictors of a sustained delusional outcome: longer duration of the index episode, temporal dissociation between psychotic features and affective symptoms, and impaired adolescent friendship pattern.
Coryell W, Keller M, Lavori P, Endicott J. Affective Syndromes, Psychotic Features, and PrognosisII. Mania. Arch Gen Psychiatry. 1990;47(7):658-662. doi:10.1001/archpsyc.1990.01810190058008