The phenomenology and response to treatment of 52 patients with an admission diagnosis of schizophrenia (N = 48) or other nonaffective illness (N = 4) satisfied research criteria for a diagnosis of mania.
All patients manifested classical phenomena of mania and many demonstrated phenomena usually associated with schizophrenia. Prevalence of affective illness and alcoholism in first-degree relatives, alcoholism in probands, the demographic characteristics of the sample, and the treatment response (particularly to lithium carbonate), were consistent with a diagnosis of affective disorder.
We suggest the prior overdiagnosis of schizophrenia resulted from failure to adequately weight cardinal phenomena of mania when they occurred in the presence of phenomena thought to be specific for the diagnosis of schizophrenia. We suggest more intensive phenomenologic investigations of schizophrenic subtypes (eg, paranoid schizophrenia) will yield a high proportion of individuals with affective illness.