Landau Kleffner Syndrome

Sir, In reference to the paper by Avasthi et al. (1996) regarding "Seasonality and Recurrent Mania" I have to say that this is very common observation which every psychiatrist do recognize i.e. many a patient do suffer only from mania year after year for many consecutive years with no trace of depression in between. I have also come across such patients which forms a respectable proportion of all affective disorder patients seen by me. Two such patients have been reported by me (Jain,1991). The retrospective study has also tried to look into differences between seasonal and non seasonal recurrent mania patients. The total number of unipolar recurrent mania with seasonal coincidence is. only eleven in this study and if divided season wise the highest number of per season is three only. To compare such a small number may not be of significance. The patients of all type of seasonal pattern can not be combined together to judge role of seasonality on disease process itself. One previous study of Garvey et. al. (1988) also compared seasonal and non-seasonal affective disorder patients and found much overlapping in most of symptom profile of the two. Rosenthal et al. (1984), mainly studying the winter depressives could find specific constellation of symptoms but their idea to implicate climatic factor as causative factor have remained controversial. Interest in the area of recurrent mania is the need of the day as it will fulf i l the paucity in this fields of research which is much common clinical entity, and has not found proper place in literature.