Late-onset delirious mania: Does it ring a bell?

IF 5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders Pub Date : 2024-02-06 DOI:10.1111/bdi.13411

Maria Aa Hansen, Robert Bering, Anders Spanggård, Pedro Barata

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引用次数: 0

Abstract

Background

Bell's mania was first described in 1849, and other terms have been used to describe this condition, including delirious mania, mania with delirium, and excited delirium. However, no international diagnostic manual has included mania as an independent diagnostic tool. The criteria for delirious mania were proposed by Bond et al.

Methods

We present a case of a man without a personal or family psychiatric history who experienced his first manic episode of delirium and psychosis at 76 years old.

Conclusions

The case described in this study is compatible with mood disorders, the original description of Bell's mania, and Bond's definition of delirious mania. Although rare, extremely late-onset primary mania can occur without personal or family psychiatric history. The initial clinical presentation of delirium requires a thorough medical investigation, including magnetic resonance imaging (MRI) and lumbar puncture with neuronal antibodies. The addition of delirious mania to the group of bipolar disorders in future editions of The International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) has therapeutic and prognostic implications. The Bond criteria can provide valuable information in this respect. Further investigations are necessary to clarify the pathophysiology and epidemiology of delirious mania.

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迟发性谵妄狂躁症：有印象吗？

背景：贝尔躁狂症于 1849 年首次被描述，其他术语也被用来描述这种病症，包括谵妄性躁狂症、伴有谵妄的躁狂症和兴奋性谵妄。然而，没有一本国际诊断手册将躁狂症列为独立的诊断工具。谵妄性躁狂症的标准由邦德等人提出：我们介绍了一例无个人或家族精神病史的男性患者，他在 76 岁时首次出现谵妄性躁狂症和精神病：本研究中描述的病例符合心境障碍、贝尔躁狂症的原始描述以及邦德对谵妄性躁狂症的定义。尽管罕见，但极晚期原发性躁狂症可能在没有个人或家族精神病史的情况下发生。谵妄的初始临床表现需要进行全面的医学检查，包括磁共振成像（MRI）和神经元抗体腰椎穿刺。在未来版本的《国际疾病分类》（ICD）和《精神疾病诊断与统计手册》（DSM）中，谵妄性躁狂症将被纳入双相情感障碍的范畴，这对治疗和预后都有影响。邦德标准可以在这方面提供有价值的信息。要弄清谵妄性躁狂症的病理生理学和流行病学，还需要进一步的研究。

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来源期刊

Bipolar Disorders 医学-精神病学

CiteScore

8.20

自引率

7.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.