Definitions of mania: concordance and prediction of outcome.

The authors compare several definitions of mania in three series of patients. All the definitions were successful in selecting patients with a favorable outcome, but there were large differences in the number of patients diagnosed, ranging from 17 to 55. The Research Diagnostic Criteria (RDC) distinction between mania and schizoaffective mania proved useful in that the schizoaffective patients continued to show schizophrenic and paranoid symptoms, had more manic episodes, and had a poorer social outcome. The DSM-III tripartite division into nonpsychotic mania and two subgroups of psychotic mania did not appear to have a clear advantage over the RDC dichotomy in the prediction of outcome.