Chronic but not resistant mania: a case report


Dr D.N. Mendhekar Room No. 619, Academic Block, G.B. Pant Hospital, New Delhi-110002


Objective:  There are many nuances of elevated mood states. At times, it becomes very difficult to diagnose a case of mania because of personality style of the patient superimposed on a cyclothymic or hyperthymic temperament. Such cases may become chronic if timely intervention is not received. We describe a case of chronic mania of 48 years of duration.

Method:  A case report.

Results:  A 65-year-old male was admitted with history of mania for around five decades. The illness commenced at prepubertal age and was continuous without any residual symptoms of note. During the course of illness, he got involved in many devastating socio-politico-legal complications. He showed good response to treatment and is currently maintained well without medication. In this case we also described some psychosocial features that may have been responsible for the chronicity of the illness.

Conclusion:  We highlighted the need for correctly identifying chronic mania, early intervention and increasing treatment awareness. This case was not treatment resistant, suggesting that chronicity per se should not denote poor outcome.