Background: In contemporary concepts of affective psychoses the existence of monopolar manias is widely questioned. Nevertheless, cases of manias with monomorphous symptomatology are reported repeatedly from all over the world. Based upon subtle observation of signs and course over many years, Karl Leonhard developed a concept of affective psychoses that permits a distinction of monopolar from bipolar forms, e.g. monopolar manias and euphoric euphorias.
Methods: As an example for the pure forms of euphorias we present two cases of hypochondriacal euphoria.
Conclusion: We discuss some of the literature relevant to the issue and propose the application of a differentiated psychopathological analysis for the discrimination of monopolar from bipolar manias.