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Am J Psychiatry 1987; 144:201-204
Copyright © 1987 by American Psychiatric Association
Sleep reduction as a final common pathway in the genesis of mania [published erratum appears in Am J Psychiatry 1987 Apr;144(4):542]
TA Wehr, DA Sack and NE Rosenthal
Diverse psychological, interpersonal, environmental, and pharmacological
factors that appear to trigger the onset of mania could act via their
capacity to cause sleep deprivation, a mechanism that has been shown in
experiments with bipolar patients to induce transient or sustained switches
into mania. Since mania in turn causes insomnia, the development of mania
is potentially self-reinforcing and could become autonomous after being
initiated by precipitating factors. The sleep reduction model is based on
experimental evidence and is a parsimonious explanation for the
precipitation of manic episodes by a wide variety of factors. Furthermore,
this model has clear implications for the prevention and treatment of mania
and provides a conceptual focus and an experimental paradigm for
psychological investigations of the causes of mania.
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