Mania associated with electroconvulsive therapy.

Of 94 depressed patients given electroconvulsive therapy (ECT), a manic episode developed in 6 (64%). These six patients were equally distributed across three diagnostic categories of depressive illness: primary unipolar depression, bipolar affective disorder, and schizoaffective disorder. Compared with matched controls, the patients who experienced ECT-associated mania had an earlier age of onset and a longer duration of illness. These patients also had more previous psychiatric hospitalizations. Although evidence of a direct causal relationship between the administration of ECT and the development of mania is still lacking, our data suggest that the risk of mania is higher in patients with certain clinical characteristics.