%0 Journal Article
%T Unipolar Mania: Recent Updates and Review of the Literature
%A Shubham Mehta
%J Psychiatry Journal
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/261943
%X Introduction. Unipolar mania (UM) has received less than the expected attention, when compared to its contemporary mood disorders, unipolar depression (UD) and bipolar disorder (BD). Method. The literature search included PUBMED and PSYCINFO databases. Cross-searches of key references were made to identify other articles of importance. Results. There seems to be a bipolar subgroup with a stable, unipolar recurrent manic course. Although UM does not have significant differences from bipolar mania in terms of sociodemographic variables, there are certain significant differences in clinical features. UM is reported to have more grandiosity, psychotic symptoms, and premorbid hyperthymic temperament, but less rapid cycling, suicidality, seasonality, and comorbid anxiety disorders. It seems to have a better course of illness with better social and professional adjustment. However, its response to lithium prophylaxis is found to be poor as compared to classical BD and valproate could be a better choice in this case. Conclusion. The available literature suggests that UM has certain differences from classical BD. The evidence, however, is insufficient to categorize it as separate diagnostic entity. However, considering UM as a course specifier of BD would be a reasonable step. 1. Introduction: Unipolar Mania¡ªThen and Now ¡°Periodic mania¡± was the term which was first used by Kraepelin (1899) to refer to some of his cases having recurrent manic episodes without depression [1]. Wernicke (1900) proposed that single or recurrent episodes of mania or depression should be viewed as distinct disorders [2], separate from the ones which follow the continuous circular course of depression, mania, and free interval or ¡°folie circulaire¡± as proposed by Falret [3]. ¡°Phasic psychoses¡± were then classified by Kleist (1911, 1953) [4, 5] and Leonhard (1957) [6] who labeled pure mania and pure melancholia as ¡°pure phasic psychoses¡± and manic-depressive psychosis as a ¡°polymorphous phasic psychosis.¡± Genetic basis for distinction between unipolar mania and manic-depressive psychosis was first suggested by Neele (1949) [7]. The evolution of unipolar mania (UM) has continued since then, despite not receiving the distinct nosological status in the two most commonly used and accepted classificatory systems of DSM and ICD. It did not find any place even in the recently introduced DSM-5 [8]. In the chapter of bipolar and related disorders, DSM-5 has clearly stated that the lifetime experience of major depressive episode is not a requirement for diagnosing bipolar I disorder. This implies
%U http://www.hindawi.com/journals/psychiatry/2014/261943/