{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:57:24Z","timestamp":1793120244120,"version":"4.5.0"},"reference-count":97,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"unspecified","delay-in-days":127,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526102466_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>While there have been reports on the relationship between cancer and depression, reports on the association between cancer and manic states, a reciprocal state of depression, have been relatively few. Therefore, we conducted a systematic review on the relationships between cancer and manic states, focusing on their etiology, clinical course, and impact on cancer treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102466_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted using four electronic databases, following the PRISMA guidelines. The scope of the study included research on manic or hypomanic states associated with cancer in patients with no prior history of mental illness, published from 1950 to August, 2021. The study protocol was registered with PROSPERO (CRD42020182372).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102466_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-six studies, including 67 cases, were identified. The etiology of manic states in cancer patients was classified into organic, drug-induced, and psychogenic, with steroids being the most predominant causative agent. Approximately half of the patients discontinued cancer treatment following the onset of manic states. This was associated with a low rate of pharmacological treatment during the acute and maintenance phase of mania. The onset of manic states was most frequent during cancer treatment; however, about 15% of the cases exhibit manic symptoms before cancer diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102466_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>This systematic review illustrated the clinical characteristics of manic state regarding differences in the etiology, timing of onset, pharmacological treatments, duration to remission, recurrence, and impact on cancer treatment. Manic states, which are comorbid with cancer, have significant clinical impacts on cancer prognosis. Therefore, appropriate pharmacological treatment for manic states is critical to consolidate appropriate cancer treatment. A substantial proportion of patients exhibit manic symptoms prior to the diagnosis of cancer, warranting further investigation into the possibility of the concept of \u201cpremonitory mania.\u201d<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526102466","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T09:59:14Z","timestamp":1778234354000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Manic and hypomanic states in cancer patients: A systematic review"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9715-5048","authenticated-orcid":false,"given":"Kyoko","family":"Osawa","sequence":"first","affiliation":[{"name":"Shiga General Hospital"},{"name":"Wakayama Medical University"},{"name":"Graduate School of Medicine, Kyoto University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1913-6955","authenticated-orcid":false,"given":"Daisuke","family":"Fujisawa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0025ww868","id-type":"ROR","asserted-by":"publisher"}],"name":"National Cancer Center Institute for Cancer Control"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"S1478951526102466_ref83","first-page":"170","article-title":"Manic defence of terminal cancer patients\u3011Gan makki kanja no souteki b\u014dei ni tsuite","volume":"4","author":"Shinozaki","year":"1994","journal-title":"T\u0101minarukea"},{"key":"S1478951526102466_ref68","first-page":"457","article-title":"mania in a patient with terminal pancreatic cancer\u3011J\u016bdo no s\u014dj\u014dtai o teishita makki suiz\u014d gan no 1 sh\u014drei","volume":"22","author":"Osawa","year":"2013","journal-title":"Psychiatry"},{"key":"S1478951526102466_ref52","doi-asserted-by":"publisher","DOI":"10.1002\/pnp.555"},{"key":"S1478951526102466_ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-005-0882-8"},{"key":"S1478951526102466_ref48","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000000728"},{"key":"S1478951526102466_ref39","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1994.tb06079.x"},{"key":"S1478951526102466_ref53","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.11.1.114"},{"key":"S1478951526102466_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2007.03.005"},{"key":"S1478951526102466_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2013.04.060"},{"key":"S1478951526102466_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S0790966700017250"},{"key":"S1478951526102466_ref50","first-page":"227","article-title":"Bipolar disorders: Evaluation and treatment","volume":"103","author":"Marzani","year":"2021","journal-title":"American Family Physician"},{"key":"S1478951526102466_ref44","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12058"},{"key":"S1478951526102466_ref56","first-page":"27","article-title":"Corticosteroid-related psychiatric complications in the treatment of Hodgkin\u2019s lymphoma in an adolescent","volume":"16","author":"Mian","year":"2007","journal-title":"Journal of the Canadian Academy of Child and Adolescent Psychiatry. 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