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A false alarm

BMJ 2009; 338 doi: (Published 05 May 2009) Cite this as: BMJ 2009;338:b1184
  1. Philip Timms, consultant psychiatrist, START team, South London and Maudsley Trust, London
  1. philip.timms{at}

    John had an undiagnosed hypomanic state for several years. His undoubted intelligence had helped to mask his pressure of speech, grandiose ideas, and thought disorder. However, he could not hold a job down and, in the end, became homeless. While hypomanic, he was arrested by the police for a rather public misdemeanour. He escaped the criminal justice system but was admitted to a locked psychiatric ward, an experience he found humiliating and disturbing.

    His symptoms were subsequently controlled with a combination of lithium …

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