ObjectivesZZPrince Sado was the tragic royal heir who was sealed in a rice chest and starved to death by his father, King Yeongjo. The question of whether he was a victim of party strife or his death was the result of his psychiatric disorder is still controversial. In this paper, we investigated the question of whether he had suffered from bipolar disorder by reviewing his psychiatric symptoms and family history. MethodsZZWe examined the available literature on Prince Sado and his family, particularly focusing on Hanjungnok (Memoirs of Lady Hyegyeong), written by Prince Sado’s wife. ResultsZZReview of the literature showed that Prince Sado suffered from psychiatric symptoms, including depressed mood, anxiety, suicidal behavior, aggressive behavior, and persecutory delusion from the age of 13 to 27. Many of his symptoms match the Diagnostic and Statistical Manual of Mental Disorders’ criteria for depressive and manic episodes and it is highly suspected that he had bipolar disorder. He also showed clothing phobia, which can be regarded as an obsessive compulsive symptom. Some of his relatives, King Gyeongjong and Sanggyegun, might have suffered from depressive disorder. ConclusionZZThe characteristics of his symptoms suggest that Prince Sado might have had bipolar disorder. His mental disorder might explain in part the cause of his death.
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