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July 1990

Affective Syndromes, Psychotic Features, and Prognosis: II. Mania

Author Affiliations

From the National Institute of Mental Health Collaborative Program on the Psychobiology of Depression-Clinical Studies, Bethesda, Md. A complete list of the participants in this research study appears at the end of this article.

Arch Gen Psychiatry. 1990;47(7):658-662. doi:10.1001/archpsyc.1990.01810190058008

• 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.