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We studied 29 patients who were admitted to a psychiatric hospital for depression, never had had a previous mania, and developed the mania in follow-up. When compared to patients who were stable unipolars, the potential bipolars had a history of more episodes prior to their onset of mania, more hospital admissions, more marked self-reproach and guilt; in follow-up, they had more hospitalizations.
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Winokur et al. (1987) studied this question.
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