Am J Psychiatry 1976; 133:765-771
Copyright © 1976 by American Psychiatric Association
Agitated psychotic depression associated with severe hypomanic episodes: a rare syndrome
JM Himmelhoch, P Coble, KJ Kupfer and J Ingenito
The authors present detailed clinical and follow-up data on 12 patients
with agitated psychotic depressions who developed serious hypomanic or
manic episodes. In six patients, each type of affective episode seemed to
merge into the others, while in the other patients there was always a clear
temporal distinction between each type of episode. The authors suggest that
the older ages of their patients may have contributed to the syndrome. They
also offer several possible theoretical explanations: the patients 1) had
mixed affective states and were trapped in the "switch" state from
depression to mania, 2) inherited both unipolar and bipolar diseases, 3)
represent a subgroup of bipolar patients, and 4) were schizoaffective.
