Factitious Disorder in a Manic Patient: Case Report and Treatment Considerations

1986 ◽  
Vol 15 (4) ◽  
pp. 365-369 ◽  
Author(s):  
Arthur Lazarus
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Signs And Symptoms ◽  
Physical Symptoms ◽  
Depressive Illness ◽  
Factitious Disorder ◽  
Manic Depressive Illness ◽  
Patient Case ◽  
Manic Depressive ◽  
Treatment Considerations

A case of factitious disorder with physical symptoms is described in a patient with manic-depressive illness. The coexistence of factitious disorder and bipolar disorder has not been previously reported. Clinicians should search for an underlying affective disorder in patients who fabricate signs and symptoms of physical illness, since mania may simulate or contribute to the production of factitious behavior.

Manic-depressive illness — II: treatment outcome in bipolar disorder subtypes

1992 ◽  
Vol 9 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Patrick McKeon ◽  
Patrick Manley ◽  
Gregory Swanwick
Keyword(s):  
Bipolar Disorder ◽  
Treatment Outcome ◽  
Antidepressant Drugs ◽  
Depressive Illness ◽  
Tricyclic Antidepressant ◽  
Rapid Cycling ◽  
Manic Depressive Illness ◽  
Mood Changes ◽  
Manic Depressive ◽  
Manic Patients

AbstractThe treatment outcome of 100 bipolar disorder patients (B.P.) was examined retrospectively to determine whether bipolar subtypes had a differential prophylactic response to lithium, carbamazepine, neuroleptics and antidepressant drugs when these treatments were given in a predetermined sequence. Sixty-eight per cent of 53 B.P.-I patients with a mania-depression-normothymic-interval (M.D.I.) sequence of mood changes had a good response to lithium, and all but one of the remainder responded with the addition of carbamazepine or an antidepressant. While only 17% of 12 unipolar manic patients achieved prophylaxis with lithium and a further 17% when carbamazepine was added, the other 66% remained normothymic when a neuroleptic was prescribed with lithium. Of the seven rapid cycling patients where depression preceded mania, 28% had a good prophylactic effect with lithium, a further 28% when a tricyclic antidepressant was added and 14% with lithium and carbamazepine. None of the 18 rapid cycling M.D.I. group had a good response to lithium, but 39% stabilised when carbamazepine was added to lithium. Twenty-eight per cent of this group failed completely to respond to any of the treatments used. Neuroleptics increased the severity and duration of depressive phases for all subtypes except the unipolar mania group.

Manic Mood Disorders

2010 ◽  
Author(s):  
Max Fink MD
Keyword(s):  
Bipolar Disorder ◽  
Severity Of Illness ◽  
Bipolar Disorders ◽  
Manic Episode ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Sleep Difficulty ◽  
Manic Depressive ◽  
Loss Of Appetite ◽  
Manic Patients

Patients suffering from mania are overactive, intrusive, excited, and belligerent. They may believe that they have special powers, are related to public figures, and can read the minds of others. They spend money lavishly. Voices on the radio or television are sometimes understood as personal communications. They speak rapidly, with illogical and confused thoughts, move constantly, and write page after page of nonsense. They typically sleep and eat poorly, have little interest in work, friends, or family, and often require restraint or seclusion. Suicide is a perpetual threat. Some manic patients are likable, while others are angry and frightening. Psychosis is a frequent feature. Manic patients believe that their parents are not their real parents, asserting that they have royal blood. They believe that they can predict the future. They know that others are watching or talking about them, and they hear voices when no one is present. Delusional mania requires more intensive treatment and almost always hospital care. In older classifications of psychiatric illnesses, these patients were considered to be suffering from a manic-depressive illness. In modern classification, this term has been discarded and the illness is now conceived as bipolar disorder for patients with manic and depressive features and major depression for those with depressive symptoms only. Bipolar disorders, ranging from mild to severe, are divided into numerous subtypes. The variety of symptoms that admit the diagnosis of bipolar disorder has led to a virtual epidemic of diagnoses of the condition. Many patients so labeled do not exhibit the sleep difficulty, loss of appetite, and loss of weight, or the severity of illness, that were the criteria for manic-depressive illness. In manic-depressive illness, the manic episode persists for hours, days, weeks, or months and interferes with normal living. Once the episode resolves, it may suddenly recur; or manic episodes may alternate with periods of depression, or occur as simultaneous mixed episodes of depression and mania. When the shift in mood from mania to depression takes place within one or a few days, the condition is labeled rapid cycling, a particularly malignant form of the illness. In manic-depressive illness, the manic episode persists for hours, days, weeks, or months and interferes with normal living.

Brain mechanisms in manic depression

1994 ◽  
Vol 40 (2) ◽  
pp. 303-308 ◽  
Author(s):  
B J Carroll
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Manic Depression ◽  
Manic Depressive Illness ◽  
Manic Depressive ◽  
Clinical Presentations ◽  
Genetic Mechanisms ◽  
Activity Information

Abstract Manic depressive illness (bipolar disorder) is the mood disorder classically considered to have a strong biological basis. During manic depressive cycles, patients show dramatic fluctuations of mood, energy, activity, information processing, and behaviors. Theories of brain function and mood disorders must deal with the case of bipolar disorder, not simply unipolar depression. Shifts in the nosologic concepts of how manic depression is related to other mood disorders are discussed in this overview, and the renewed adoption of the Kraepelinian "spectrum" concept is recommended. The variable clinical presentations of manic depressive illness are emphasized. New genetic mechanisms that must be considered as candidate factors in relation to this phenotypic heterogeneity are discussed. Finally, the correlation of clinical symptom clusters with brain systems is considered in the context of a three-component model of manic depression.

Manic-Depressive Illness in Adolescence: A Case Report

1978 ◽  
Vol 17 (3) ◽  
pp. 514-520 ◽  
Author(s):  
Frederick W. Engstrom ◽  
Douglas R. Robbins ◽  
J. Gary May
Keyword(s):  
Case Report ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Manic Depressive

The Beast in White’s Jungle: Manic-Depressive Illness

2018 ◽  
Author(s):  
Patricia Moran
Keyword(s):  
Bipolar Disorder ◽  
Virginia Woolf ◽  
Family Members ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Manic Depressive ◽  
Key Sites

This chapter discusses White’s illness within the context of medical and subjective accounts of bipolar disorder. It opens with a selective overview of White’s life that highlights the key sites of disruption and signs of illness. It then turns to an overview of manic-depressive illness, followed by a more detailed description of the characteristics of manic, depressive and mixed episodes. It ends with a brief comparison of White’s experiences of illness to those of her contemporary Virginia Woolf. This comparison demonstrates not only the diverse expressions of manic-depressive illness but also the different approaches that the writers themselves as well as family members adopted to cope with it.

Bipolar disorder

2017 ◽  
pp. 233-252 ◽  
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Mood Stabilizers ◽  
Manic Depressive Illness ◽  
Bipolar Illness ◽  
Manic Depressive ◽  
Additional Section

‘Bipolar disorder’ provides an account of the clinical and scientific aspects of bipolar disorder (‘manic depressive illness’). Identification of varying degrees of mood elevation is critical to the diagnosis of bipolar disorder to allow its distinction from unipolar depression, and the phenomenology and classification of manic states is described in detail. The range of aetiological factors involved in the development of bipolar illness is covered, from genetics and brain structure to psychology and life events. The efficacy of treatments both psychological and pharmacological in bipolar disorder is assessed, including new approaches with psychoeducation, atypical antipsychotic drugs, and anticonvulsant mood stabilizers. An additional section covers the clinically challenging treatment of bipolar depression. The evidence from clinical trials is then placed in the context of good clinical management of both the acute phases of bipolar illness as well as longer-term maintenance treatment.

The genealogy of the clinical syndrome of mania: signs and symptoms described in psychiatric texts from 1880 to 1900

2017 ◽  
Vol 48 (10) ◽  
pp. 1573-1591 ◽  
Author(s):  
K. S. Kendler
Keyword(s):  
Signs And Symptoms ◽  
Depressive Illness ◽  
Clinical Syndrome ◽  
Manic Depressive Illness ◽  
Sexual Drive ◽  
Manic Symptoms ◽  
Manic Depressive ◽  
Moral Standards ◽  
Psychological Medicine ◽  
Modern Form

AbstractIn 1800, mania was conceptualized as an agitated psychotic state. By 1900, it closely resembled its modern form. This paper reviews the descriptions of mania in Western psychiatry from 1880 to 1900, when Kraepelin was training and developing his concept of manic-depressive illness. Psychiatric textbooks published 1900–1960 described 22 characteristic manic symptoms/signs the presence of which were recorded in 25 psychiatric textbooks and three other key documents published 1880–1900. Descriptions of mania in these nineteenth century textbooks closely resembled those in the twentieth century, recording a mean (s.d.) of 15.9 (2.3) and 17.0 (2.3) of the characteristic symptoms, respectively (p= 0.12). The frequency with which individual symptoms were reported was substantially correlated in these two periods (r= +0.64). Mendel's 1881 monograph, Kraepelin's first description of mania in 1883 and the entry for mania in Tuke's Dictionary of Psychological Medicine (1892) described a mean (s.d.) of 19 (1.7) of these characteristic symptoms. These descriptions of mania often contained phenomenologically rich descriptions of euphoria, hyperactivity, grandiosity, flight of ideas, and poor judgment. They also emphasized several features not in DSM criteria including changes in character, moral standards and physical appearance, and increased sense of humor and sexual drive. Fifteen authors described key symptoms/signs of mania most reporting elevated mood, motoric hyperactivity and accelerated mental processes. By 1880, the syndrome of mania had been largely stabilized in its modern form. In the formation of his concept of manic-depressive illness, Kraepelin utilized the syndrome of mania as described in the psychiatric community in which he was trained.

The Impact of Mood Stabilizers on Suicide in Bipolar Disorder: A Comparative Analysis

CNS Spectrums ◽  
2000 ◽  
Vol 5 (S1) ◽  
pp. 12-18 ◽  
Author(s):  
Frederick K. Goodwin ◽  
S. Nassir Ghaemi
Keyword(s):  
Bipolar Disorder ◽  
Suicide Risk ◽  
Depressive Illness ◽  
Mood Stabilizers ◽  
Manic Depressive Illness ◽  
Stabilizing Agents ◽  
Manic Depressive ◽  
Suicide Risk Factors ◽  
Serotonergic Function ◽  
The Impact

AbstractWhich mood stabilizers are the most effective in reducing suicide rates in patients with bipolar disorder? This paper reviews the literature and compares the data on two types of mood-stabilizing agents, lithium and anticonvulsants. Compared with the large amount of data on lithium, there is surprising little information available on the effects of anticonvulsants on mortality in manic-depressive illness. Each was also assessed in terms of suicide risk factors such as depression and mixed episodes, rapid cycling, substance abuse, anxiety and panic, and central serotonergic function. Only two studies that provide data demonstrating anticonvulsant efficacy in preventing suicide in bipolar disorder are available, and the data are incomplete at best. Further research in this area should include an emphasis on the outcome of mortality in patients treated with any of the anticonvulsants or with lithium-anticonvulsant combinations.

The characteristic signs and symptoms of mania and depression according to Kraepelin circa 1905: a comparison with DSM-III

2020 ◽  
pp. 1-6
Author(s):  
Kenneth S. Kendler
Keyword(s):  
Diagnostic Criteria ◽  
Signs And Symptoms ◽  
Depressive Illness ◽  
Direct Link ◽  
Manic Depressive Illness ◽  
Manic Depressive ◽  
The Usa ◽  
Involutional Melancholia ◽  
Symptoms And Signs ◽  
Historical Origins

Abstract Although the rise of operationalized diagnostic criteria and the creation of DSM-III were influenced in the USA by a neo-Kraepelinian ‘revival’ of interest in psychiatric nosology, Kraepelin was only a distal influence on the specific diagnostic criteria proposed. The historical origins of the DSM-III criteria for mania and major depression (MD) are traceable back to the 1950s and contain no direct link to Kraepelin's writings. George Dreyfus, a student and assistant to Kraepelin, authored in 1907 a monograph on Involutional Melancholia which reviewed cases seen by Kraepelin in Heidelberg. In this monograph, Dreyfus presents the ‘characteristic’ symptoms for mania and depression ‘as described by Kraepelin.’ This historical finding provides the unprecedented opportunity to examine the resemblance between the criteria proposed for mania and depression in DSM-III, inspired by Kraepelin's nosologic vision, and those specifically suggested by Kraepelin 73 years earlier. Kraepelin's symptoms and signs for mania paralleled seven of the eight DSM-III criteria (except the decreased need for sleep), with two not included in DSM-III (increased mental activity and short bursts of sadness). Kraepelin's signs and symptoms paralleled six of the nine DSM-III criteria for MD, lacking suicidal ideation and changes in appetite/weight and sleep but including obsessions, reduced expressive movements, and decreased mood responsiveness. Although Kraepelin's overall approach to mania and depression emphasized their close inter-relationship in the cyclic course of manic-depressive illness, it is noteworthy Kraepelin's ‘characteristic’ symptoms for mania and depression as described by Dreyfus, bear substantial but incomplete resemblance to the criteria proposed in DSM-III.

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