Unipolar mania: a distinct clinical entity?

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Abstract
Of the 241 Li clinic patients at the New York State Psychiatric Institute [USA] with bipolar I affective disorder, 38 (15.7%) were never hospitalized or somatically treated for depression. These unipolar manic patients had a significantly lower incidence of rapid cycling and suicide attempts than other bipolar I patients. No differences were found in risk of illness in 1st degree relatives. Li was an effective prophylactic agent in these patients. Some patients originally classified as unipolar manic had depressive episodes with additional information and clinical observation. Unipolar mania appears to be a subgroup of bipolar I illness, but there are no data to support the hypothesis that it is a separate entity.

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