Chronic mania: An unexpectidly long episode?

Mood disorders (unipolar and bipolar disorders) are one of the most distressing and disabling disorders known to man kind. Mood disorders may present as either a depressive phase or manic phase. Chronic mania by definition means presence of manic symptoms in excess of 2 yrs without remission. Chronic mania differs in its psychopathological presentation from the acute mania. Chronic mania also poses a diagnostic and management challenge. Along with the poor response to the treatment these patients are also likely to suffer from severe impairment in the social, familial, interpersonal and occupational functioning. These disturbances may add to the chronicity of the condition. This case underlines the significance of keeping possibility of chronic mania which has been overlooked in the recent literature.

Disability assessment in mental illnesses using Indian Disability Evaluation Assessment Scale (IDEAS).

BACKGROUND & OBJECTIVE: Psychiatric disorders cause disability in individuals and pose significant burden on their families. In most of the cases residual disability and poor quality of life continue even after disability evaluation in patients with chronic mental illness in very important. The present study was undertaken to assess and compare the disability in patients with schizophrenia and obsessive-compulsive disorder (OCD) using Indian Disability Evaluation Assessment Scale (IDEAS). METHODS: Patients diagnosed to have schizophrenia and OCD with mild severity of illness were included in the study. Indian Disability Evaluation Assessment Scale (IDEAS) was applied. Disability was assessed in these patients on all domains of IDEAS. RESULTS: Majority of the patients with schizophrenia were from rural areas whereas most of the patients with OCD were from urban background. There was comparable disability in the patients with schizophrenia with duration of illness in the range of 2-5 yr and >5 yr. Significant disability in work and global score was seen in patients of obsessive-compulsive disorder with duration of illness >5 yr. Patients with schizophrenia had significantly higher disability in all domains than patients with OCD. INTERPRETATION & CONCLUSION: Schizophrenia causes greater disability than obsessive-compulsive disorder in patients. These illnesses affect all areas of daily functioning leading to greater disability, and thus increasing the burden on the family, pose greater challenge for the rehabilitation of patients and their inclusion in the mainstream of the family and society. Further studies on a larger sample need to be done to confirm the finding.