Will mania survive DSM-5 and ICD-11?

As a natural phenomenon, mania without major depression will of course survive DSM-5 and ICD-11, but following its integration as a diagnosis into bipolar-I disorder (BP-I) in those manuals, BP-I will be more heterogeneous and, paradoxically, will include a unipolar disorder. Furthermore, unipolar mania will no longer be adequately identified and coded as an independent disorder in public health statistics. Mania without major depression, with prevalence rates of 1.7–1.8 %, is even more common than schizophrenia. This brief review of our current, still insufficient, knowledge suggests strongly that pure unipolar mania, as well as mania with minor depressive disorders, should remain important elements of the three-dimensional mood spectrum. Research should focus on dimensional and not on simplified categorical models, which entail a considerable loss of information.