The British Journal of Psychiatry


A patient is described who, in the course of a febrile illness during an influenza epidemic, first showed symptoms of an acute confusional state which then developed into a manic psychosis of prolonged duration. During the entire period of her psychiatric illness she had unusually high levels of Influenza A antibody titre which were at the extreme range compared to influenza patients tested at a general hospital; moreover her titres remained abnormally high for an unusual period of time as compared to other influenza patients. Because of transient clinical signs suggesting an encephalitis during the initial stages of her illness, the possibility of influenza infection causing subclinical organic brain changes which in turn became manifest in the form of a manic psychosis is discussed, and the concept of `functional' affective psychosis is challenged.