The expression of bipolar affective disorders in brain injured patients.
OBJECTIVE
A prospective study was designed to investigate the varied presentations of major affective disorders in patients with organic brain disease.


METHODS
Patients admitted to our neuropsychiatry service, with affective and behavioral disturbances, and known neurological disorders, were classified, on phenomenological grounds, into the following groups: 1) elated mania; 2) irritable mania; 3) affective lability with periods of irritability, but without other symptoms pathognomonic for mania; and 4) intermittent psychosis with absent or ambiguous mood changes.


RESULTS
A majority of patients in all four groups responded to pharmacotherapy with anti-cycling agents.


CONCLUSIONS
It is proposed that these groups represent different expressions of mania in brain injured persons, and that these expressions range through a spectrum of phenomenology, included elated mania, irritable mania, episodic psychosis and explosive organic personality disorder. The DSM-III-R classification of these disorders, and approaches to their clinical management, are discussed.
Jefferson Medical College, Philadelphia.
A S
AS
Zwil
T W
TW
McAllister
E
E
Raimo
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000374:Aggression; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001927:Brain Diseases / Q000523:psychology*; D003702:Delusions / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales
D000319:Adrenergic beta-Antagonists; D000928:Antidepressive Agents; D014150:Antipsychotic Agents