Mania - Wikipedia

The symptoms of mania include elevated mood (either euphoric or irritable), flight of ideas and pressure of speech, increased energy, decreased need and desire ... Mania FromWikipedia,thefreeencyclopedia Jumptonavigation Jumptosearch Stateofabnormallyelevatedorirritablemood,arousal,and/orenergylevels Forotheruses,seeMania(disambiguation). "Maniacal"redirectshere.Forotheruses,seeManiacal(disambiguation). MedicalconditionManiaOthernamesManicsyndrome,manicepisodeGraphicalrepresentationofmania,cyclothymiaandhypomaniaSpecialtyPsychiatry Mania,alsoknownasmanicsyndrome,isamentalandbehavioraldisorder[1]definedasastateofabnormallyelevatedarousal,affect,andenergylevel,or"astateofheightenedoverallactivationwithenhancedaffectiveexpressiontogetherwithlabilityofaffect."[2]Duringamanicepisode,anindividualwillexperiencerapidlychangingemotionsandmoods,highlyinfluencedbysurroundingstimuli.Althoughmaniaisoftenconceivedasa"mirrorimage"todepression,theheightenedmoodcanbeeithereuphoricordysphoric.[3]Asthemaniaintensifies,irritabilitycanbemorepronouncedandresultinanxietyoranger. Thesymptomsofmaniaincludeelevatedmood(eithereuphoricorirritable),flightofideasandpressureofspeech,increasedenergy,decreasedneedanddesireforsleep,andhyperactivity.Theyaremostplainlyevidentinfullydevelopedhypomanicstates.However,infull-blownmania,theyundergoprogressivelysevereexacerbationsandbecomemoreandmoreobscuredbyothersignsandsymptoms,suchasdelusionsandfragmentationofbehavior.[4] Contents 1Causesanddiagnosis 2Classification 2.1Mixedstates 2.2Hypomania 2.3Associateddisorders 3Signsandsymptoms 4Causes 5Mechanism 6Diagnosis 7Treatment 8Societyandculture 9Etymology 10Seealso 11References 12Furtherreading 13Externallinks Causesanddiagnosis[edit] Maniaisasyndromewithmultiplecauses.Althoughthevastmajorityofcasesoccurinthecontextofbipolardisorder,itisakeycomponentofotherpsychiatricdisorders(suchasschizoaffectivedisorder,bipolartype)andmayalsooccursecondarytovariousgeneralmedicalconditions,suchasmultiplesclerosis;certainmedicationsmayperpetuateamanicstate,forexampleprednisone;orsubstancespronetoabuse,especiallystimulants,suchascaffeineandcocaine.InthecurrentDSM-5,hypomanicepisodesareseparatedfromthemoreseverefullmanicepisodes,which,inturn,arecharacterizedaseithermild,moderate,orsevere,withcertaindiagnosticcriteria(e.g.catatonia,psychosis).Maniaisdividedintothreestages:hypomania,orstageI;acutemania,orstageII;anddeliriousmania(delirium),orstageIII.This"staging"ofamanicepisodeisusefulfromadescriptiveanddifferentialdiagnosticpointofview[5] Maniavariesinintensity,frommildmania(hypomania)todeliriousmania,markedbysuchsymptomsasdisorientation,floridpsychosis,incoherence,andcatatonia.[6]StandardizedtoolssuchasAltmanSelf-RatingManiaScale[7]andYoungManiaRatingScale[8]canbeusedtomeasureseverityofmanicepisodes.Becausemaniaandhypomaniahavealsolongbeenassociatedwithcreativityandartistictalent,[9]itisnotalwaysthecasethattheclearlymanic/hypomanicbipolarpatientneedsorwantsmedicalhelp;suchpersonsofteneitherretainsufficientself-controltofunctionnormallyorareunawarethattheyhave"gonemanic"severelyenoughtobecommittedortocommitthemselves.[citationneeded]Manicpersonsoftencanbemistakenforbeingundertheinfluenceofdrugs.[10] Classification[edit] Mixedstates[edit] Mainarticle:Mixedaffectivestate Inamixedaffectivestate,theindividual,thoughmeetingthegeneralcriteriaforahypomanic(discussedbelow)ormanicepisode,experiencesthreeormoreconcurrentdepressivesymptoms.Thishascausedsomespeculation,amongclinicians,thatmaniaanddepression,ratherthanconstituting"true"polaropposites,are,rather,twoindependentaxesinaunipolar—bipolarspectrum. Amixedaffectivestate,especiallywithprominentmanicsymptoms,placesthepatientatagreaterriskforsuicide.Depressiononitsownisariskfactorbut,whencoupledwithanincreaseinenergyandgoal-directedactivity,thepatientisfarmorelikelytoactwithviolenceonsuicidalimpulses. Hypomania[edit] Mainarticle:Hypomania Hypomania,whichmeans"lessthanmania",[11]isaloweredstateofmaniathatdoeslittletoimpairfunctionordecreasequalityoflife.[12]Althoughcreativityandhypomaniahavebeenhistoricallylinked,areviewandmeta-analysisexploringthisrelationshipfoundthatthisassumptionmaybetoogeneralandempiricalresearchevidenceislacking.[13]Inhypomania,thereislessneedforsleepandbothgoal-motivatedbehaviourandmetabolismincrease.Somestudiesexploringbrainmetabolisminsubjectswithhypomania,however,didnotfindanyconclusivelink;whiletherearestudiesthatreportedabnormalities,somefailedtodetectdifferences.[14]Thoughtheelevatedmoodandenergyleveltypicalofhypomaniacouldbeseenasabenefit,truemaniaitselfgenerallyhasmanyundesirableconsequencesincludingsuicidaltendencies,andhypomaniacan,iftheprominentmoodisirritableasopposedtoeuphoric,bearatherunpleasantexperience.Inaddition,theexaggeratedcaseofhypomaniacanleadtoproblems.Forinstance,trait-basedpositivityforapersoncouldmakethemmoreengagingandoutgoing,andcausethemtohaveapositiveoutlookinlife.[15]Whenexaggeratedinhypomania,however,suchapersoncandisplayexcessiveoptimism,grandiosity,andpoordecisionmaking,oftenwithlittleregardtotheconsequences.[15] Associateddisorders[edit] Asinglemanicepisode,intheabsenceofsecondarycauses,(i.e.,substanceusedisorders,pharmacologics,orgeneralmedicalconditions)isoftensufficienttodiagnosebipolarIdisorder.HypomaniamaybeindicativeofbipolarIIdisorder.Manicepisodesareoftencomplicatedbydelusionsand/orhallucinations;andifthepsychoticfeaturespersistforadurationsignificantlylongerthantheepisodeoftypicalmania(twoweeksormore),adiagnosisofschizoaffectivedisorderismoreappropriate.Certainobsessive-compulsivespectrumdisordersaswellasimpulsecontroldisorderssharethesuffix"-mania,"namely,kleptomania,pyromania,andtrichotillomania.Despitetheunfortunateassociationimpliedbythename,however,noconnectionexistsbetweenmaniaorbipolardisorderandthesedisorders. Furthermore,evidenceindicatesaB12deficiencycanalsocausesymptomscharacteristicofmaniaandpsychosis.[16] Hyperthyroidismcanproducesimilarsymptomstothoseofmania,suchasagitation,elevatedmood,increasedenergy,hyperactivity,sleepdisturbancesandsometimes,especiallyinseverecases,psychosis.[17][18] Signsandsymptoms[edit] AmanicepisodeisdefinedintheAmericanPsychiatricAssociation'sdiagnosticmanualasa"distinctperiodofabnormallyandpersistentlyelevated,expansive,orirritablemoodandabnormallyandpersistentlyincreasedactivityorenergy,lastingatleast1weekandpresentmostoftheday,nearlyeveryday(oranyduration,ifhospitalizationisnecessary),"[19]wherethemoodisnotcausedbydrugs/medicationoranon-mentalmedicalillness(e.g.,hyperthyroidism),and:(a)iscausingobviousdifficultiesatworkorinsocialrelationshipsandactivities,or(b)requiresadmissiontohospitaltoprotectthepersonorothers,or(c)thepersonhaspsychosis.[20] Tobeclassifiedasamanicepisode,whilethedisturbedmoodandanincreaseingoal-directedactivityorenergyispresent,atleastthree(orfour,ifonlyirritabilityispresent)ofthefollowingmusthavebeenconsistentlypresent: Inflatedself-esteemorgrandiosity. Decreasedneedforsleep(e.g.,feelsrestedafter3hoursofsleep). Moretalkativethanusual,oractspressuredtokeeptalking. Flightsofideasorsubjectiveexperiencethatthoughtsareracing. Increaseingoal-directedactivity,orpsychomotoracceleration. Distractibility(tooeasilydrawntounimportantorirrelevantexternalstimuli). Excessiveinvolvementinactivitieswithahighlikelihoodofpainfulconsequences.(e.g.,extravagantshopping,improbablecommercialschemes,hypersexuality).[20] Thoughtheactivitiesoneparticipatesinwhileinamanicstatearenotalwaysnegative,thosewiththepotentialtohavenegativeoutcomesarefarmorelikely. Ifthepersonisconcurrentlydepressed,theyaresaidtobehavingamixedepisode.[20] TheWorldHealthOrganization'sclassificationsystemdefinesamanicepisodeasonewheremoodishigherthantheperson'ssituationwarrantsandmayvaryfromrelaxedhighspiritstobarelycontrollableexuberance,isaccompaniedbyhyperactivity,acompulsiontospeak,areducedsleeprequirement,difficultysustainingattention,and/oroftenincreaseddistractibility.Frequently,confidenceandself-esteemareexcessivelyenlarged,andgrand,extravagantideasareexpressed.Behaviorthatisout-of-characterandrisky,foolishorinappropriatemayresultfromalossofnormalsocialrestraint.[4] Somepeoplealsohavephysicalsymptoms,suchassweating,pacing,andweightloss.Infull-blownmania,oftenthemanicpersonwillfeelasthoughtheirgoal(s)areofparamountimportance,thattherearenoconsequences,orthatnegativeconsequenceswouldbeminimal,andthattheyneednotexerciserestraintinthepursuitofwhattheyareafter.[21]Hypomaniaisdifferent,asitmaycauselittleornoimpairmentinfunction.Thehypomanicperson'sconnectionwiththeexternalworld,anditsstandardsofinteraction,remainintact,althoughintensityofmoodsisheightened.Butthosewithprolongedunresolvedhypomaniadoruntheriskofdevelopingfullmania,andmaycrossthat"line"withoutevenrealizingtheyhavedoneso.[22] Oneofthesignaturesymptomsofmania(andtoalesserextent,hypomania)iswhatmanyhavedescribedasracingthoughts.Theseareusuallyinstancesinwhichthemanicpersonisexcessivelydistractedbyobjectivelyunimportantstimuli.[23]Thisexperiencecreatesanabsent-mindednesswherethemanicindividual'sthoughtstotallypreoccupythem,makingthemunabletokeeptrackoftime,orbeawareofanythingbesidestheflowofthoughts.Racingthoughtsalsointerferewiththeabilitytofallasleep. Manicstatesarealwaysrelativetothenormalstateofintensityoftheaffectedindividual;thus,alreadyirritablepatientsmayfindthemselveslosingtheirtempersevenmorequickly,andanacademicallygiftedpersonmay,duringthehypomanicstage,adoptseemingly"genius"characteristicsandanabilitytoperformandarticulateatalevelfarbeyondthatwhichtheywouldbecapableofduringeuthymia.Averysimpleindicatorofamanicstatewouldbeifaheretoforeclinicallydepressedpatientsuddenlybecomesinordinatelyenergetic,enthusiastic,cheerful,aggressive,or"over-happy".Other,oftenlessobvious,elementsofmaniaincludedelusions(generallyofeithergrandeurorpersecution,accordingtowhetherthepredominantmoodiseuphoricorirritable),hypersensitivity,hypervigilance,hypersexuality,hyper-religiosity,hyperactivityandimpulsivity,acompulsiontooverexplain(typicallyaccompaniedbypressureofspeech),grandioseschemesandideas,andadecreasedneedforsleep(forexample,feelingrestedafteronly3or4hoursofsleep).Inthecaseofthelatter,theeyesofsuchpatientsmaybothlookandseemabnormally"wideopen",rarelyblinking,andmaycontributetosomeclinicians'erroneousbeliefthatthesepatientsareundertheinfluenceofastimulantdrug,whenthepatient,infact,iseithernotonanymind-alteringsubstancesorisactuallyonadepressantdrug.Individualsmayalsoengageinout-of-characterbehaviorduringtheepisode,suchasquestionablebusinesstransactions,wastefulexpendituresofmoney(e.g.,spendingsprees),riskysexualactivity,abuseofrecreationalsubstances,excessivegambling,recklessbehavior(suchasextremespeedingorotherdaredevilactivity),abnormalsocialinteraction(e.g.over-familiarityandconversingwithstrangers),orhighlyvocalarguments.Thesebehavioursmayincreasestressinpersonalrelationships,leadtoproblemsatwork,andincreasetheriskofaltercationswithlawenforcement.Thereisahighriskofimpulsivelytakingpartinactivitiespotentiallyharmfultotheselfandothers.[24][25] Although"severelyelevatedmood"soundssomewhatdesirableandenjoyable,theexperienceofmaniaisultimatelyoftenquiteunpleasantandsometimesdisturbing,ifnotfrightening,forthepersoninvolvedandforthoseclosetothem,anditmayleadtoimpulsivebehaviourthatmaylaterberegretted.Itcanalsooftenbecomplicatedbytheindividual'slackofjudgmentandinsightregardingperiodsofexacerbationofcharacteristicstates.Manicpatientsarefrequentlygrandiose,obsessive,impulsive,irritable,belligerent,andfrequentlydenyanythingiswrongwiththem.[citationneeded]Becausemaniafrequentlyencourageshighenergyanddecreasedperceptionofneedorabilitytosleep,withinafewdaysofamaniccycle,sleep-deprivedpsychosismayappear,furthercomplicatingtheabilitytothinkclearly.Racingthoughtsandmisperceptionsleadtofrustrationanddecreasedabilitytocommunicatewithothers. Maniamayalso,asearliermentioned,bedividedintothree“stages”.StageIcorrespondswithhypomaniaandmayfeaturetypicalhypomaniccharacteristics,suchasgregariousnessandeuphoria.InstagesIIandIIImania,however,thepatientmaybeextraordinarilyirritable,psychoticorevendelirious.Theselattertwostagesarereferredtoasacuteanddelirious(orBell's),respectively. Causes[edit] Varioustriggershavebeenassociatedwithswitchingfromeuthymicordepressedstatesintomania.Onecommontriggerofmaniaisantidepressanttherapy.Studiesshowthattheriskofswitchingwhileonanantidepressantisbetween6-69percent.Dopaminergicdrugssuchasreuptakeinhibitorsanddopamineagonistsmayalsoincreaseriskofswitch.OthermedicationpossiblyincludeglutaminergicagentsanddrugsthataltertheHPAaxis.Lifestyletriggersincludeirregularsleep-wakeschedulesandsleepdeprivation,aswellasextremelyemotionalorstressfulstimuli.[26] Variousgenesthathavebeenimplicatedingeneticstudiesofbipolarhavebeenmanipulatedinpreclinicalanimalmodelstoproducesyndromesreflectingdifferentaspectsofmania.CLOCKandDBPpolymorphismshavebeenlinkedtobipolarinpopulationstudies,andbehavioralchangesinducedbyknockoutarereversedbylithiumtreatment.Metabotropicglutamatereceptor6hasbeengeneticallylinkedtobipolar,andfoundtobeunder-expressedinthecortex.Pituitaryadenylatecyclase-activatingpeptidehasbeenassociatedwithbipolaringenelinkagestudies,andknockoutinmiceproducesmanialike-behavior.TargetsofvarioustreatmentssuchasGSK-3,andERK1havealsodemonstratedmanialikebehaviorinpreclinicalmodels.[27] Maniamaybeassociatedwithstrokes,especiallycerebrallesionsintherighthemisphere.[28][29] DeepbrainstimulationofthesubthalamicnucleusinParkinson'sdiseasehasbeenassociatedwithmania,especiallywithelectrodesplacedintheventromedialSTN.AproposedmechanisminvolvesincreasedexcitatoryinputfromtheSTNtodopaminergicnuclei.[30] Therearecertainpsychoactivedrugsthatcaninduceastateofmanicpsychosis,including:amphetamine,cathinone,cocaine,MDMA,methamphetamine,methylphenidate,oxycodone,phencyclidine,designerdrugs,etc.[31] Maniacanalsobecausedbyphysicaltraumaorillness.Whenthecausesarephysical,itiscalledsecondarymania.[32] Mechanism[edit] Furtherinformation:Biologyofbipolardisorder Themechanismunderlyingmaniaisunknown,buttheneurocognitiveprofileofmaniaishighlyconsistentwithdysfunctionintherightprefrontalcortex,acommonfindinginneuroimagingstudies.[33][34]Variouslinesofevidencefrompost-mortemstudiesandtheputativemechanismsofanti-manicagentspointtoabnormalitiesinGSK-3,[35]dopamine,ProteinkinaseCandInositolmonophosphatase.[36] Metaanalysisofneuroimagingstudiesdemonstrateincreasedthalamicactivity,andbilaterallyreducedinferiorfrontalgyrusactivation.[37]Activityintheamygdalaandothersubcorticalstructuressuchastheventralstriatumtendtobeincreased,althoughresultsareinconsistentandlikelydependentupontaskcharacteristicssuchasvalence.Reducedfunctionalconnectivitybetweentheventralprefrontalcortexandamygdalaalongwithvariablefindingssupportsahypothesisofgeneraldysregulationofsubcorticalstructuresbytheprefrontalcortex.[38]Abiastowardspositivelyvalencedstimuli,andincreasedresponsivenessinrewardcircuitrymaypredisposetowardsmania.[39]Maniatendstobeassociatedwithrighthemispherelesions,whiledepressiontendstobeassociatedwithlefthemispherelesions.[40] Post-mortemexaminationsofbipolardisorderdemonstrateincreasedexpressionofProteinKinaseC(PKC).[41]Whilelimited,somestudiesdemonstratemanipulationofPKCinanimalsproducesbehavioralchangesmirroringmania,andtreatmentwithPKCinhibitortamoxifen(alsoananti-estrogendrug)demonstratesantimaniceffects.TraditionalantimanicdrugsalsodemonstratePKCinhibitingproperties,amongothereffectssuchasGSK3inhibition.[34] Manicepisodesmaybetriggeredbydopaminereceptoragonists,andthiscombinedwithtentativereportsofincreasedVMAT2activity,measuredviaPETscansofradioligandbinding,suggests aroleofdopamineinmania.Decreasedcerebrospinalfluidlevelsoftheserotoninmetabolite5-HIAAhavebeenfoundinmanicpatientstoo,whichmaybeexplainedbyafailureofserotonergicregulationanddopaminergichyperactivity.[42] Limitedevidencesuggeststhatmaniaisassociatedwithbehavioralrewardhypersensitivity,aswellaswithneuralrewardhypersensitivity.ElectrophysiologicalevidencesupportingthiscomesfromstudiesassociatingleftfrontalEEGactivitywithmania.AsleftfrontalEEGactivityisgenerallythoughttobeareflectionofbehavioralactivationsystemactivity,thisisthoughttosupportaroleforrewardhypersensitivityinmania.Tentativeevidencealsocomesfromonestudythatreportedanassociationbetweenmanictraitsandfeedbacknegativityduringreceiptofmonetaryrewardorloss.Neuroimagingevidenceduringacutemaniaissparse,butonestudyreportedelevatedorbitofrontalcortexactivitytomonetaryreward,andanotherstudyreportedelevatedstriatalactivitytorewardomission.Thelatterfindingwasinterpretedinthecontextofeitherelevatedbaselineactivity(resultinginanullfindingofrewardhypersensitivity),orreducedabilitytodiscriminatebetweenrewardandpunishment,stillsupportingrewardhyperactivityinmania.[43]Punishmenthyposensitivity,asreflectedinanumberofneuroimagingstudiesasreducedlateralorbitofrontalresponsetopunishment,hasbeenproposedasamechanismofrewardhypersensitivityinmania.[44] Diagnosis[edit] IntheICD-10thereareseveraldisorderswiththemanicsyndrome:organicmanicdisorder(F06.30),maniawithoutpsychoticsymptoms(F30.1),maniawithpsychoticsymptoms(F30.2),othermanicepisodes(F30.8),unspecifiedmanicepisode(F30.9),manictypeofschizoaffectivedisorder(F25.0),bipolardisorder,currentepisodemanicwithoutpsychoticsymptoms(F31.1),bipolaraffectivedisorder,currentepisodemanicwithpsychoticsymptoms(F31.2). Treatment[edit] Beforebeginningtreatmentformania,carefuldifferentialdiagnosismustbeperformedtoruleoutsecondarycauses. Theacutetreatmentofamanicepisodeofbipolardisorderinvolvestheutilizationofeitheramoodstabilizer(carbamazepine,valproate,lithium,orlamotrigine)oranatypicalantipsychotic(olanzapine,quetiapine,risperidone,aripiprazole,orcariprazine).[45]TheuseofantipsychoticagentsinthetreatmentofacutemaniawasreviewedbyTohenandVietain2009.[46] Whenthemanicbehaviourshavegone,long-termtreatmentthenfocusesonprophylactictreatmenttotrytostabilizethepatient'smood,typicallythroughacombinationofpharmacotherapyandpsychotherapy.Thelikelihoodofhavingarelapseisveryhighforthosewhohaveexperiencedtwoormoreepisodesofmaniaordepression.Whilemedicationforbipolardisorderisimportanttomanagesymptomsofmaniaanddepression,studiesshowrelyingonmedicationsaloneisnotthemosteffectivemethodoftreatment.Medicationismosteffectivewhenusedincombinationwithotherbipolardisordertreatments,includingpsychotherapy,self-helpcopingstrategies,andhealthylifestylechoices.[47][medicalcitationneeded] Lithiumistheclassicmoodstabilizertopreventfurthermanicanddepressiveepisodes.Asystematicreviewfoundthatlongtermlithiumtreatmentsubstantiallyreducestheriskofbipolarmanicrelapse,by42%.[48]Anticonvulsantssuchasvalproate,oxcarbazepineandcarbamazepinearealsousedforprophylaxis.Morerecentdrugsolutionsincludelamotrigineandtopiramate,bothanticonvulsantsaswell. Insomecases,long-actingbenzodiazepines,particularlyclonazepam,areusedafterotheroptionsareexhausted.Inmoreurgentcircumstances,suchasinemergencyrooms,lorazepam,combinedwithhaloperidol,isusedtopromptlyalleviatesymptomsofagitation,aggression,andpsychosis. AntidepressantmonotherapyisnotrecommendedforthetreatmentofdepressioninpatientswithbipolardisordersIorII,andnobenefithasbeendemonstratedbycombiningantidepressantswithmoodstabilizersinthesepatients.Someatypicalantidepressants,however,suchasmirtazepineandtrazodonehavebeenoccasionallyusedafterotheroptionshavefailed.[49] Societyandculture[edit] InElectroboy:AMemoirofManiabyAndyBehrman,hedescribeshisexperienceofmaniaas"themostperfectprescriptionglasseswithwhichtoseetheworld...lifeappearsinfrontofyoulikeanoversizedmoviescreen".[50]Behrmanindicatesearlyinhismemoirthatheseeshimselfnotasapersonwithanuncontrollabledisablingillness,butasadirectorofthemoviethatishisvividandemotionallyalivelife.Thereissomeevidencethatpeopleinthecreativeindustrieshavebipolardisordermoreoftenthanthoseinotheroccupations.[51][better source needed] WinstonChurchillhadperiodsofmanicsymptomsthatmayhavebeenbothanassetandaliability.[52] EnglishactorStephenFry,whohasbipolardisorder,[53]recountsmanicbehaviourduringhisadolescence:"WhenIwasabout17...goingaroundLondonontwostolencreditcards,itwasasortoffantasticreinventionofmyself,anattemptto.Iboughtridiculoussuitswithstiffcollarsandsilktiesfromthe1920s,andwouldgototheSavoyandRitzanddrinkcocktails."[54]Whilehehasexperiencedsuicidalthoughts,hesaysthemanicsideofhisconditionhashadpositivecontributionsonhislife.[53] Etymology[edit] Thenosologyofthevariousstagesofamanicepisodehaschangedoverthedecades.ThewordderivesfromtheAncientGreekμανία(manía),"madness,frenzy"[55]andtheverbμαίνομαι(maínomai),"tobemad,torage,tobefurious".[56] Seealso[edit] Abnormalpsychology Adultattentiondeficithyperactivitydisorder Bipolardisorder Cyclothymia Hyperthymia Hypomania Peoplewithbipolardisorder InternationalSocietyforBipolarDisorders Majordepressivedisorder YoungManiaRatingScale Dancingmania References[edit] 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SchizoaffectiveDisorder.2007SeptemberMayoClinic.RetrievedOctober1,2007. SchizoaffectiveDisorderArchived2011-08-18attheWaybackMachine.2004May.AllPsychOnline:VirtualPsychologyClassroom.RetrievedOctober2,2007. PsychoticDisorders.2004May.AllPsychOnline:VirtualPsychologyClassroom.RetrievedOctober2,2007. Sajatovic,Martha;DiBiovanni,SueKim;Bastani,Bijan;Hattab,Helen;Ramirez,LuisF.(1996)."Risperidonetherapyintreatmentrefractoryacutebipolarandschizoaffectivemania".PsychopharmacologyBulletin.32(1):55–61.PMID 8927675. Externallinks[edit] LookupmaniainWiktionary,thefreedictionary. BipolarManiaSymptoms DepressionandBipolarSupportAlliance ClassificationDICD-10:F06.30,F30.1,F30.2,F30.8,F30.9,F31.1,F31.2ICD-9-CM:296.0,296.4,296.6MeSH:D001714 vteMooddisorderSpectrumBipolardisorder BipolarI BipolarII Cyclothymia BipolarNOS Childhood Hypomania Mania Mixedaffectivestate Rapidcycling Depression Majordepressivedisorder Dysthymia Seasonalaffectivedisorder Atypicaldepression Melancholicdepression Majordepressiveepisode Comorbidities Schizoaffectivedisorder Symptoms Delusion Depression(differentialdiagnoses) Emotionaldysregulation Anhedonia Dysphoria Suicidalideation Hallucination Moodswing Sleepdisorder Hypersomnia Insomnia Psychosis Psychoticdepression Racingthoughts Reducedaffectdisplay Diagnosis BipolarSpectrumDiagnosticScale ChildManiaRatingScale GeneralBehaviorInventory HypomaniaChecklist MoodDisorderQuestionnaire Ratingscalesfordepression YoungManiaRatingScale TreatmentAnticonvulsants Carbamazepine Lamotrigine Oxcarbazepine Valproate Sodiumvalproate Valproatesemisodium Sympathomimetics,SSRIsandsimilar Bupropion Dextroamphetamine Escitalopram Fluoxetine Methylphenidate Sertraline Othermoodstabilizers Antipsychotics Atypicalantipsychotics Lithium Lithiumcarbonate Lithiumcitrate Lithiumsulfate Lithiumtoxicity Non-pharmaceutical Clinicalpsychology Cognitivebehavioraltherapy Dialecticalbehaviortherapy Electroconvulsivetherapy Involuntarycommitment Lighttherapy Psychotherapy Transcranialmagneticstimulation History EmilKraepelin FrederickK.Goodwin JohnCade KarlLeonhard KayRedfieldJamison MogensSchou vteMentaldisorders (Classification)AdultpersonalityandbehaviorSexual Ego-dystonicsexualorientation Paraphilia Fetishism Voyeurism Sexualmaturationdisorder Sexualrelationshipdisorder Other Factitiousdisorder Munchausensyndrome Genderdysphoria Intermittentexplosivedisorder Dermatillomania Kleptomania Pyromania Trichotillomania Personalitydisorder ChildhoodandlearningEmotionalandbehavioral ADHD Conductdisorder ODD Emotionalandbehavioraldisorders Separationanxietydisorder Movementdisorders Stereotypic Socialfunctioning DAD RAD Selectivemutism Speech Cluttering Stuttering Ticdisorder Tourettesyndrome Intellectualdisability X-linkedintellectualdisability Lujan–Frynssyndrome Psychologicaldevelopment(developmentaldisabilities) Pervasive Specific Mood(affective) Bipolar BipolarI BipolarII BipolarNOS Cyclothymia Depression Atypicaldepression Dysthymia Majordepressivedisorder Melancholicdepression Seasonalaffectivedisorder Mania NeurologicalandsymptomaticAutismspectrum Autism Aspergersyndrome High-functioningautism PDD-NOS Savantsyndrome Dementia AIDSdementiacomplex Alzheimer'sdisease Creutzfeldt–Jakobdisease Frontotemporaldementia Huntington'sdisease Mildcognitiveimpairment Parkinson'sdisease Pick'sdisease Sundowning Vasculardementia Wandering Other Delirium Organicbrainsyndrome Post-concussionsyndrome Neurotic,stress-relatedandsomatoformAdjustment Adjustmentdisorderwithdepressedmood AnxietyPhobia Agoraphobia Socialanxiety Socialphobia Anthropophobia Specificsocialphobia Specificphobia Claustrophobia Other Generalizedanxietydisorder OCD Panicattack Panicdisorder Stress Acutestressdisorder PTSD Dissociative Depersonalization-derealizationdisorder Dissociativeidentitydisorder Fuguestate Psychogenicamnesia Somaticsymptom Bodydysmorphicdisorder Conversiondisorder Gansersyndrome Globuspharyngis Psychogenicnon-epilepticseizures Falsepregnancy Hypochondriasis Masspsychogenicillness Nosophobia Psychogenicpain Somatizationdisorder PhysiologicalandphysicalbehaviorEating Anorexianervosa Bulimianervosa Ruminationsyndrome Otherspecifiedfeedingoreatingdisorder Nonorganicsleep Hypersomnia Insomnia Parasomnia Nightterror Nightmare REMsleepbehaviordisorder Postnatal Postpartumdepression Postpartumpsychosis SexualdysfunctionArousal Erectiledysfunction Femalesexualarousaldisorder Desire Hypersexuality Hypoactivesexualdesiredisorder Orgasm Anorgasmia Delayedejaculation Prematureejaculation Sexualanhedonia Spontaneousorgasm Pain Nonorganicdyspareunia Nonorganicvaginismus Psychoactivesubstances,substanceabuseandsubstance-related Drugoverdose Intoxication Physicaldependence Reboundeffect Stimulantpsychosis Substancedependence Withdrawal Schizophrenia,schizotypalanddelusionalDelusional Delusionaldisorder Folieàdeux Psychosisandschizophrenia-like Briefreactivepsychosis Schizoaffectivedisorder Schizophreniformdisorder Schizophrenia Childhoodschizophrenia Disorganized(hebephrenic)schizophrenia Paranoidschizophrenia Pseudoneuroticschizophrenia Simple-typeschizophrenia Other Catatonia Symptomsanduncategorized Impulse-controldisorder Klüver–Bucysyndrome Psychomotoragitation Stereotypy Authoritycontrol:Nationallibraries Ukraine CzechRepublic Retrievedfrom"https://en.wikipedia.org/w/index.php?title=Mania&oldid=1116440659" 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