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Manic patients with schizophrenic or paranoid symptoms

SYNOPSIS A study of 32 patients meeting criteria for ‘schizomanic’ psychosis is described. These psychoses account for about 1 % of hospital admissions. Very few first-degree relatives had either schizophrenia or mania. Lithium seemed an effective treatment. Twenty-four patients made a full recovery, and the series as a whole was closer to manic depressive psychosis than schizophrenia on all outcome measures. Some diagnostic clues are suggested to help the clinician to recognize the patients with a poor prognosis. These findings are in line with other studies, and suggest that most of these patients should be regarded as manic. This conclusion should lead to some revision of present ideas on the incidence and diagnosis of mania.