Affective syndromes, psychotic features, and prognosis. II. Mania

Arch Gen Psychiatry. 1990 Jul;47(7):658-62. doi: 10.1001/archpsyc.1990.01810190058008.


Fifty-six patients with mania and psychotic features and 14 with schizoaffective disorder, manic type, were followed up with biannual assessments during a 5-year period. Results were treated as they were in an analogous follow-up of patients with psychotic major depression or schizoaffective disorder, depressed type. Patients with schizoaffective mania experienced more morbidity during follow-up than did patients with psychotic mania. Among patients with schizoaffective mania, those with a chronic subtype did far worse than did the others, while the mainly schizophrenic--mainly affective distinction was not predictive. When depressed and manic groups were combined (n = 173), the following baseline variables were significant independent predictors of a sustained delusional outcome: longer duration of the index episode, temporal dissociation between psychotic features and affective symptoms, and impaired adolescent friendship pattern.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / psychology
  • Chronic Disease
  • Delusions / diagnosis
  • Delusions / psychology
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Marriage
  • Prognosis
  • Psychiatric Status Rating Scales
  • Psychology, Adolescent
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology
  • Schizophrenia / diagnosis
  • Schizophrenic Psychology
  • Social Adjustment