Sudden glory revisited: Cognitive contents of hypomania

Introduction: Cognitive aspects of hypomania have been historically neglected. Although they do not have an etiological role, they may be essential to understand factors underlying the hypomanic ascent in bipolar disorders and constitute key modulators of the course of illness. Methods: We have performed a critical review of the existing literature on the role of cognition during hypomania, considering outputs coming from very different fields of knowledge. Results: There is a nuclear cognitive change occurring in most hypomanic phases that we have defined as 'anastrophic' thinking. This key cognitive procedure has several implications - going from social sciences and philosophy to basic sciences. Conclusions: Hypomania has received certain attention from cognitive theorists. Unfortunately, this attention has not been translated into a cognitive model that is as robust as the one seen in depression. The inclusion of certain psychological aspects in models of hypomania should give rise, as occurred with depression, to an increased emphasis on psychoeducation and cognitive modification of behavioral patterns in the management of this disorder with combined psychological and pharmacological tools. Copyright (c) 2007 S. Karger AG, Basel.