Delirious mania in the elderly

Delirious mania is a clinical syndrome in which the signs and symptoms of d elirium manifest themselves in the context of a manic episode. Though there have been numerous descriptions and case reports of this syndrome, all hav e described mania as the presenting feature, with signs of delirium develop ing subsequently, and none of the vignettes have involved elderly patients. We report two casts of elderly individuals with mania who initially presen ted as in a delirium. Both of them experienced clear manic episodes, which were confirmed by their psychiatric histories and clinical responses to moo d stabilizers. Mania needs to be in the differential diagnosis of elderly p eople presenting with confusion, disorientation, and perceptual changes, pa rticularly in those with a history of bipolar disorder. Copyright (C) 2001 John Wiley & Sons, Ltd.