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Mania and the use of lithium: a three-year study.

The authors focus on the problem of differential diagnosis between mania and schizophrenia and also upon the toxic aspects of lithium therapy. An approach to the diagnostic evaluation of the psychotic patient is urged that recognizes several positive criteria for mania and schizophrenia and relates them to the temporal sequence of the diagnostic process. Diagnostic confusion regarding delirium in patients on lithium and the problems of weekend coverage and supervision by personnel unfamiliar with lithium treatment are seen as special problems that must be dealt with to prevent severe toxic reactions.