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February 1973

The Stages of Mania: A Longitudinal Analysis of the Manic Episode

Author Affiliations

Bethesda, Md
From the Section on Psychiatry, Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Md.

Arch Gen Psychiatry. 1973;28(2):221-228. doi:10.1001/archpsyc.1973.01750320053009

The progression of symptoms during an acute manic episode was studied retrospectively in 20 bipolar manic-depressive patients whose diagnosis was reconfirmed at follow-up. Three stages were delineated, the most severe of which was manifested by bizarre behavior, hallucinations, paranoia, and extreme dysphoria. Despite symptoms that might have otherwise prompted a diagnosis of schizophrenia, patients appeared clearly manic both earlier in the course and later as the episode was resolving.

The level of functioning was ascertained at follow-up and compared statistically with the level of psychotic disorganization during the acute manic episode; no relationship was found. The advantages of using a longitudinal view of a psychotic episode as a diagnostic tool is discussed.

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