Anxiety and the Severity of Mania


Researchers from Spain, noting that “anxiety has scarcely been studied in acute mania,” analyzed data from 242 patients admitted for a diagnosis of acute mania (per DSM-IV TR criteria). Anxiety was associated with the severity of manic symptoms to an extremely significant degree (P < 0.0001, where any p value less than 0.05 is considered significant), and patients with anxiety were hospitalized 20% longer. Results were published online May 24, 2012 by Acta Psychiatrica Scandinavica.

Abstract → 

Gonzalez-Pinto, A. Galan, J. Martin-Carrasco, M. Ballesteros, J. Maurino, J. Vieta, E. Anxiety as a Market of Severity in Acute Mania. Acta Psychiatrica Scandinavica. Published online May 24, 2012


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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Good title, and this is why I pay no attention to these studies. Maybe in ten or fifteen years after a few more clinical studies, researchers will tentatively ask if anxiety is also a feature in schizophrenia. This isn’t rocket science, it’s a make work scheme for academics.

    Conclusion:  An association of anxiety symptoms with greater severity in acute mania was demonstrated. The close relationship between anxiety and manic symptoms highlights the need for greater clinical attention to anxiety in this population. Further studies are necessary to determine whether effective treatment of anxiety symptoms could improve clinical and care outcomes.

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  2. Hmmm. I interpreted this as meaning that being anxious about situations worthy of anxiety intensified (and I think might possibly cause) manic episodes. Some of what is called “mania” strikes me as trying desperately to run away from a threat or unresolved stress that can’t effectively be bargained with such as hyper-vigilance and sleep deprivation on top of real and oppressive stresses that a person does not have the resources to fix.

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    • I totally agree. Then, it could be said that drugging the person exhibiting the life state you describe so well, and is called *mania*- would in effect be handicapping that person- by further limiting his inner resources. It may be that problem- that *deficit* caused by the treatment itself, that the psychiatrist portends to solve—-by gradually crippling the person’s own resources until chronic illness and disability are proven to be the biggest obstacle to a *cure* or *recovery*- Proof of the severity of the disease that the psychiatrist created so as to have something to fix or control.

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