Clinical profile of mania in children and adolescents from the Indian subcontinent.
OBJECTIVE
To see whether classic DSM-III-R criteria for mania are applicable to Indian youngsters and to examine the clinical presentation of mania in an Indian child and adolescent psychiatric sample.


METHODS
Fifty subjects with a diagnosis of functional psychosis as per the definition in ICD-9 were recruited from the population referred during the study period of approximately one year (n = 840) to the Child and Adolescent Psychiatry (CAP) clinic of the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, South India. The subjects were systematically evaluated using a standardized clinical interview and demographic questionnaire and were classified according to DSM-III-R. The subjects who satisfied DSM-III-R criteria for mania formed the sample for this study.


RESULTS
Twenty-one subjects received a diagnosis of mania according to DSM-III-R. The most common symptoms of mania included pressure of speech, irritability, elation, distractibility, increased self-esteem, expansive mood, flight of ideas, and grandiose delusions. No subject had comorbid attention-deficit hyperactivity disorder (ADHD). Additionally, 13 (61%) of the 21 manic subjects had delusions and/or hallucinations. The other common symptoms included psychomotor agitation, reduced sleep, anger, temper tantrums, decreased concentration, disobedience, aggression, and hyperactivity.


CONCLUSIONS
Mania was diagnosable in Indian children and adolescents using classic DSM-III-R criteria. The clinical profile appears to be generally similar to that seen in adults. ADHD is not a comorbid condition. The presence of aggressive or disruptive behaviours and hyperactivity in childhood- and adolescent-onset mania, however, could lead to a misdiagnosis of attention-deficit hyperactivity disorder/conduct disorder (ADHD/CD). Similarly, the presence of psychotic features could lead to a misdiagnosis of schizophrenia.
Reddy
Y C
YC
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India. jreddy@nimhans.ren.nic.in
Girimaji
S
S
Srinath
S
S
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D003906:Developing Countries; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics