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II. Mania

William Coryell, MD; Martin Keller, MD; Philip Lavori, PhD; Jean Endicott, PhD

Arch Gen Psychiatry. 1990;47(7):658-662.

Abstract
• 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.

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.

Footnotes
Accepted for publication November 3, 1989.

Reprint requests to University of Iowa, Department of Psychiatry, 500 Newton Rd, Iowa City, IA 52242 (Dr Coryell).

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