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Study of a Patient With 48-Hour Manic-Depressive Cycles:  Part II. Strong Positive Correlation Between Endocrine Factors and Manic Defense Patterns

WILLIAM E. BUNNEY JR., MD; ERNEST L. HARTMANN, MD; JOHN W. MASON, MD
Arch Gen Psychiatry. 1965;12(6):619-625. doi:10.1001/archpsyc.1965.01720360091015.
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PART I of this investigation reported the behavioral analysis of a patient with regular 48-hour manic-depressive cycles. These cycles persisted with clock-like regularity over a twoyear period of time. The second part of this study is concerned with biochemical and physiological variables as they relate to the periodic behavioral cycles in this unusual patient.

The patient, Mrs. J, was a 43-year-old, Caucasian, married female. On her depressed or low days she was retarded, expressed feelings of suffering and hopelessness, and had an acute awareness of the duration, severity, and the cyclic aspects of her illness. On the manic or high day she was hyperactive, angry, at times combative, and denied intensely the severity, the duration, and the periodic 24-hour changes in her behavior.

Urinary 17-hydroxycorticosteroids (17OHCS) were selected for the major focus of the endocrine aspect of this investigation.

A number of workers have reported

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