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Open Access Highly Accessed Research article

Clinical features of delirious mania: a series of five cases and a brief literature review

Bo-Shyan Lee12, Si-Sheng Huang123, Wen-Yu Hsu12 and Nan-Ying Chiu124*

Author Affiliations

1 Department of Psychiatry, Lu-Tung Branch of Changhua Christian Hospital, Changhua, Taiwan

2 Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan

3 Center of General Education, Central Taiwan University of Science and Technology, Taichung, Taiwan

4 Chang Jung Christian University, Tainan, Taiwan

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BMC Psychiatry 2012, 12:65  doi:10.1186/1471-244X-12-65

Published: 21 June 2012

Abstract

Background

Little is known about the cause and psychopathology of delirious mania, a type of disorder where delirium and mania occur at the same time. This condition still has no formal diagnostic classification. To provide more information about this potentially life-threatening condition, we studied five patients with delirious mania.

Methods

We describe the cases of five patients with delirious mania admitted to an acute inpatient psychiatric unit between January 2005 and January 2007, and discuss the cases in the context of a selective review of the clinical literature describing the clinical features and treatment of delirious mania.

Results

Two patients had two episodes of delirious mania. Delirium usually resolved faster than mania though not always the case. Delirious mania remitted within seven sessions of the electroconvulsive therapy (ECT).

Conclusions

Delirious mania is a potentially life-threatening but under-recognized neuropsychiatric syndrome. Delirious mania that is ineffectively treated may induce a new-onset manic episode or worsen an ongoing manic episode, and the patient will need prolonged hospitalization. Delirious mania also has a close relationship with catatonia. Early recognition and aggressive treatment, especially with electroconvulsive therapy, can significantly reduce morbidity and mortality.

Keywords:
Bipolar disorder; Delirium; Electroconvulsive therapy; Mania; Catatonia