Psychologically stressful events in the precipitation of manic episodes

The case notes of all 67 manic patients admitted to the psychiatric wing of a District General Hospital over a period of two years were screened for evidence of independent life events during a four week period prior to admission. The nature of such events and of the underlying stresses was examined and the data obtained were compared with data from a control group of acute surgical admissions. Four times as many manic patients had an independent life event closely preceding their admission. It is concluded that stress in the form of loss or threat is a common precipitant of mania. Some surprising findings are focused upon and discussed.