title: Unipolar mania: a necessary diagnostic concept.
abstract: In the classification of mood disorders, major depressive disorder is separate from bipolar disorders whereas mania is not. Studies on pure mania are therefore rare. Our paper reviews the evidence for distinguishing pure mania (M) and mania with mild depression (Md) from bipolar disorder. Two large epidemiological studies found a prevalence of 1.7-1.8% of M/Md in adolescents and adults. Several clinical follow-up studies demonstrated good stability of the diagnosis after a previous history of three manic episodes. Compared to bipolar disorder, manic disorder is characterised by a weaker family history for depression, an earlier onset, fewer recurrences and better remission, and is less comorbid with anxiety disorders. In addition, mania is strongly associated with a hyperthymic temperament, manifests more psychotic symptoms and is more often treated with antipsychotics. Twin and family studies find mania to be more heritable than depression and show no significant transmission from depression to mania or from mania to depression. Cardiovascular mortality is elevated among patients with mood disorders generally and is highest among those with mania. In non-Western countries, mania and the manic episodes in bipolar disorder are reported to occur more frequently than in Western countries.
authors: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland, jules.angst@uzh.ch.
authors: Jules
authors: J
authors: Angst
authors: Christoffel
authors: C
authors: Grobler
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis*; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D019964:Mood Disorders / Q000145:classification* / Q000175:diagnosis* / Q000266:history
references: Arch Gen Psychiatry. 1978 Jun;35(6):773-82
references: 655775
references: World J Biol Psychiatry. 2000 Oct;1(4):187-9
references: 12607214
references: Compr Psychiatry. 2007 May-Jun;48(3):213-7
references: 17445513
references: J Affect Disord. 1992 Jan;24(1):35-41
references: 1545043
references: Arch Gen Psychiatry. 2012 Sep;69(9):943-51
references: 22566563
references: Br J Psychiatry. 1994 Apr;164(4):547-9
references: 8038947
references: J Affect Disord. 2005 Aug;87(2-3):193-201
references: 15913783
references: J Affect Disord. 1979 Mar;1(1):59-68
references: 162182
references: Psychopathology. 2001 Nov-Dec;34(6):312-7
references: 11847491
references: Eur Arch Psychiatry Clin Neurosci. 2004 Apr;254(2):82-91
references: 15146337
references: J Affect Disord. 2001 Dec;67(1-3):3-19
references: 11869749
references: Psychother Psychosom. 2012;81(4):235-43
references: 22584147
references: Psychopathology. 2002 Mar-Jun;35(2-3):171-5
references: 12145505
references: Psychiatry J. 2014;2014:261943
references: 24877052
references: Am J Psychiatry. 1979 Nov;136(11):1420-3
references: 495794
references: J Affect Disord. 2014 Jan;152-154:52-6
references: 24210629
references: Mol Psychiatry. 2014 Feb;19(2):153-5
references: 24365866
references: Br J Psychiatry. 1994 Sep;165(3):413
references: 7994528
references: Curr Psychiatry Rep. 2009 Dec;11(6):475-80
references: 19909670
references: Arch Gen Psychiatry. 2003 May;60(5):497-502
references: 12742871
references: Biol Psychiatry. 1976 Feb;11(1):31-42
references: 1260075
references: Br J Psychiatry. 1982 Nov;141:453-8
references: 7150881
references: Br J Psychiatry. 1982 Nov;141:459-63
references: 6129912
references: Acta Psychiatr Scand Suppl. 1966;194:172-89
references: 5229228
references: Encephale. 2008 Sep;34(4):337-42
references: 18922234
references: Bipolar Disord. 2009 Sep;11(6):637-49
references: 19689506
references: Mol Psychiatry. 2014 Feb;19(2):214-9
references: 24126930
references: Am J Psychiatry. 2003 Nov;160(11):2049-51
references: 14594755
references: Eur Psychiatry. 1999 Jul;14 (4):199-204
references: 10572348
references: Psychiatr Genet. 2000 Mar;10(1):43-9
references: 10909128
references: J Affect Disord. 2002 Sep;71(1-3):97-103
references: 12167505
references: J Psychosom Res. 2012 Sep;73(3):175-9
references: 22850256
references: Int J Neuropsychopharmacol. 2011 Sep;14(8):1017-27
references: 21396153
references: Br J Psychiatry. 2007 Mar;190:189-91
references: 17329735
references: Confin Psychiatr. 1975;18(1):1-15
references: 1192723
references: J Affect Disord. 2011 Aug;132(3):356-9
references: 21459455
references: Turk Psikiyatri Derg. 2012 Fall;23(3):201-5
references: 22949290
references: Eur Arch Psychiatry Clin Neurosci. 2013 Aug;263(5):425-34
references: 23124773
references: Indian J Psychiatry. 1983 Oct;25(4):251-9
references: 21847300
references: Aust N Z J Psychiatry. 1992 Sep;26(3):450-3
references: 1417631
references: Br J Psychiatry. 1985 Oct;147:434-7
references: 4075034
references: Mol Psychiatry. 2014 Feb;19(2):209-13
references: 24126925
references: Clin Psychol Rev. 2005 May;25(3):307-39
references: 15792852