Depression During Mania: Clinical Observations and Theoretical Implications
JOEL KOTIN M.D.1, and
FREDERICK K. GOODWIN M.D.
1 Assistant Adjunct Professor of Psychiatry, Department of Psychiatry and Human Behavior, University of California at Irvine, and Assistant Chief, Crisis Intervention Center and Outpatient Department, Orange County Medical Center, 101 City Dr. South, Orange, Calif. 92668
In the course of longitudinal studies of patients with manic-depressive illness, the authors regularly observed clear features of depression during periods of acute mania. The relationship of depression to mania in 20 hospitalized patients was systematically investigated through an analysis of nurses' and physicians' behavioral ratings and notes. Statistically significant positive associations between mania and depression were found in the majority of cases. The psychological implications of the concurrent presence of depression and mania are discussed.
