ABSTRACT
The Diagnostic and Statistical Manual of Mental Disorders ([DSM-IV], American Psychiatric Press, 1994) defines a manic episode as a distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or shorter if hospitalization is necessary), with three (four if only irritability is present) or more of the following symptoms present to a significant degree: inflated self esteem or gran-diosity; decreased need for sleep; more talkative than usual; flight of ideas or a subjective experience that thoughts are racing; distractibility by unimportant and irrelevant external stimuli; increase in goal directed activity or psychomotor agitation; and an excessive involvement in pleasurable activities that have a high potential for painful or negative consequences. The mood disturbance must be sufficiently severe to cause marked impairment in occupational and social functioning, sometimes requiring hospitalization to prevent harm to self or others, and may be accompanied by psychotic symptoms. Although the DSM-IV definition of mania does not include those associated with pharmacologically induced states, medical or neurological conditions, these states are important to recognize as they have significant implications for assessment, investigations and management.
