Mania due to general medical conditions: frequency, treatment, and cost

Mania due to general medicine conditions may occur in patients in a variety of settings.

We reviewed the charts of patients admitted to an adult psychiatric service over a nine-year period (Jan. 1985 to Dec. 1993). Patients were diagnosed with Organic Affective Syndrome (ICD-9 code 293.83) in 241 episodes (N = 227 patients). There were forty-seven manic or mixed episodes in forty patients (0.72% of all admissions).

When DSM-IV criteria for Mood Disorder due to a General Medical Condition manic or mixed type (MDGMC) was applied, we found twenty-five patients with twenty-seven episodes (N = 30 treatment trials). Irritable mood predominated in twenty-seven (90%) of the thirty trials.

Treatment included anticonvulsants in 63 percent, neuroleptics 63 percent, and lithium 40 percent. Favorable responses to anticonvulsants were seen; however combination therapy was used more frequently. Further research in this area is needed.