Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.
Department of Psychiatry, Regionspsykiatrien Gødstrup, Herning, Denmark.
Bipolar Disord. 2024 Jun;26(4):331-334. doi: 10.1111/bdi.13411. Epub 2024 Feb 6.
Bell's mania was first described in 1849, and other terms have been used to describe this condition, including delirious mania, mania with delirium, and excited delirium. However, no international diagnostic manual has included mania as an independent diagnostic tool. The criteria for delirious mania were proposed by Bond et al.
We present a case of a man without a personal or family psychiatric history who experienced his first manic episode of delirium and psychosis at 76 years old.
The case described in this study is compatible with mood disorders, the original description of Bell's mania, and Bond's definition of delirious mania. Although rare, extremely late-onset primary mania can occur without personal or family psychiatric history. The initial clinical presentation of delirium requires a thorough medical investigation, including magnetic resonance imaging (MRI) and lumbar puncture with neuronal antibodies. The addition of delirious mania to the group of bipolar disorders in future editions of The International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) has therapeutic and prognostic implications. The Bond criteria can provide valuable information in this respect. Further investigations are necessary to clarify the pathophysiology and epidemiology of delirious mania.
贝尔氏躁狂症于 1849 年首次被描述，其他术语也被用来描述这种情况，包括谵妄性躁狂症、伴意识障碍的躁狂症和兴奋性谵妄。然而，没有国际诊断手册将躁狂症作为一种独立的诊断工具纳入其中。谵妄性躁狂症的标准由 Bond 等人提出。
我们报告了一例无个人或家族精神病史的患者，他在 76 岁时首次出现谵妄性躁狂和精神病发作。
本研究中描述的病例符合心境障碍、贝尔氏躁狂症的原始描述以及 Bond 对谵妄性躁狂症的定义。尽管罕见，但极晚发性原发性躁狂症可在无个人或家族精神病史的情况下发生。谵妄的初始临床表现需要进行彻底的医学调查，包括磁共振成像（MRI）和带有神经元抗体的腰椎穿刺。在未来的《国际疾病分类》（ICD）和《精神障碍诊断与统计手册》（DSM）版本中，将谵妄性躁狂症添加到双相障碍组中具有治疗和预后意义。Bond 标准在这方面提供了有价值的信息。需要进一步的研究来阐明谵妄性躁狂症的病理生理学和流行病学。
