Diagnosing Mania in the Age of DSM-5.

DSM-5 describes the primary criterion of mania as being “a distinct period of abnormally and persistently elevated, expansive, or irritable mood” and “abnormally and persistently increased goal-directed activity or energy.” One of our forefathers of psychiatric phenomenology, Emil Kraepelin, referred to this phenomenon a century ago, suggesting that “increased busyness” was the most striking feature of mania (1). He elegantly described it as follows: