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What Is the 'Core' Symptom of Mania?-Reply

Mark S. Bauer, MD; Paul Crits-Christoph, PhD; Peter C. Whybrow, MD
Arch Gen Psychiatry. 1993;50(1):71-72. doi:10.1001/archpsyc.1993.01820130077014.
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In Reply.—  We are pleased that Gard- ner and Wenegrat find the issue of the core characteristics of mania of sufficient importance to respond to our article. It has frankly been a mystery to us that the phenomenology of mania and hypomania has not received more sustained attention, since our current knowledge is so rudimentary. Unfortunately, they have misconstrued the two major findings of our study in their attempt to apply these data to support their theory of "sociophysiology."Gardner and Wenegrat recapitulate the commonly held conception that "a clinical hallmark of the manic state is feeling more positively than one has reason to feel." However, data from our study together with data from many others1-9 clearly do not support the hypothesis that euphoric or elevated mood is essential to the manic syndrome. In our study the manic syndrome sample had highly variable scores, both on the Well-Being subscale and

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