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Short-Term Outcome in Manic Patients with Delusions or Hallucinations

Hospital records of 101 DSM-III-R bipolar manic patients were reviewed retrospectively to study the short-term treatment outcome of manic patients with delusions or hallucinations. There were fifty eight(57.4 % ) manic patients with delusions or hallucinations and forty three(42. 6%) manic patients without delusions and hallucinations. All patients underwent necessary treatments by their physicians. Manic symptoms, i.e., elated mood irritable mood, verbal activity, and motor activity were rated on admission and weekly for four weeks after admission by a retrospective review of records. On admission, the total severity of manic symptoms, elated mood, and irritable mood were significantly greater in the manic patients with delusions or hallucinations than the manic patients without delusions and hallucinations. At one week after admission, all symptoms improved markedly, about 50% improvement over the severity at the time of admission, and there were no significant differences in severity of manic symptoms between two groups. Thereafter all symptoms improved rather slowly in both groups and there were no significant differences in severity of manic symptoms between two groups in subsequent 3 weeks. Average daily doses of antimanic medications administered were compared between two groups. Only during first week of hospitalization the manic patients with delusions or hallucinations received significantly higher daily doses(776.5土 881.2mg chlorpromazine-equivalent doses) of antipsychotics than the manic patients without delusions and hallucinations (414.2 ±289.7mg chlorpromazine-equivalent doses). There were no significant differences in lithium and carbamazepine doses between two groups. These results suggest that the psychotic symptoms do not seem to affect aucte treatment outcome in mania, if treated appropriately