Depuis sa création, la nosographie psychiatrique a connu de nombreuses refontes sous l’influence de courants de pensée parfois opposés, bouleversant irrémédiablement son vocabulaire et ses classifications. La « fureur maniaque », concept ancien aux limites floues, illustre bien cette évolution. Notre recherche vise à analyser les origines de ce diagnostic, à en analyser les modifications au fil du temps et à questionner sa place actuelle dans les classifications psychiatriques, entre entité autonome et symptôme d’un trouble plus vaste.

Notre travail s’est basé sur une revue de la littérature scientifique psychiatrique publiée à partir de la fin du XVIIIe siècle jusqu’à nos jours. Les mots-clés utilisés étaient « fureur maniaque » et « manie coléreuse », en anglais et français. Toutes les publications pertinentes en rapport avec notre objet d’étude ont été sélectionnées.

Le concept de « fureur maniaque » est apparu au XIXe siècle, désignant une forme de grande folie marquée par des accès de violence incontrôlables, mus par un délire praxique. Cette entité a été progressivement remodelée, donnant naissance à des diagnostics modernes comme la personnalité antisociale. Bien que certains troubles actuels partagent des symptômes similaires (agitation, agressivité, impulsivité), ils diffèrent par leur étiologie et leur ancrage nosographique. Le DSM-5 ne semble pas disposer de diagnostic permettant de capturer pleinement la dimension psychotique de la fureur maniaque, réduite à des troubles de l’humeur ou à des troubles du comportement. La clinique décrite par les premiers aliénistes échappe ainsi aux catégories actuelles. Il paraît donc indispensable de repenser cette pathologie, afin de lui permettre de retrouver une place dans notre nosographie actuelle.

Madness is an ancient human reality, but psychiatry, as a formal medical discipline, is relatively recent. In just two centuries, this specialty has undergone profound transformations, constantly reshaping its classifications and diagnoses under the influence of often opposing intellectual currents. From the alienists of the 19th century to the contemporary DSM-V, definitions of mental disorders have evolved and mutated, significantly altering both the perception of symptoms and the strategies for treatment. Our study focuses on the notion of manic fury , an archaic concept that serves as a particularly illustrative case of the evolution of psychiatric thought. This research emerged from a clinical encounter with a young female patient who presented sudden and uncontrollable episodes of violence, for which this rare and largely forgotten diagnosis was considered. This work centers on the clinical definition of manic fury, its historical origins, the evolution of its meaning, and its positioning within the modern classification of mental disorders. We also explore its connections to mood disorders and psychotic illnesses, and examine whether it should be considered an autonomous nosological entity or rather integrated into another existing clinical framework.

Our research was based on a thorough review of psychiatric scientific literature, published from the late 18th century to the present day. Keywords used included “manic fury” and “furious mania,” in both English and French. All relevant publications related to our topic were included in the analysis.

Manic fury is an old psychiatric concept, first described in the 19th century by Pinel and Fodéré, then reshaped over time. Originally, it referred to a severe form of madness characterized by extreme psychomotor agitation and uncontrollable violent acts, without ideational delusion or hallucinations. The violent act itself was considered a delusional expression, referred to as “praxic delusion”. Over the centuries, this concept underwent profound transformations. It was fragmented into different modern entities, such as antisocial personalities or psychopathy. At the same time, the term “manic fury” was reused within the framework of bipolar disorder to designate the most severe forms of manic agitation, marked by irritability, aggressiveness, and restlessness. Despite these evolutions, a symptomatic continuity remains: regardless of the period, psychomotor agitation, irritability, and aggressiveness constitute the core symptoms of manic fury. The main difference lies in the etiological interpretation: on the one hand, psychosis revealed through violent action; on the other, mood disturbance integrated into bipolar disorders. This shift in perspective has major consequences in terms of treatment and prognosis. An analysis of contemporary classifications, notably the DSM-V, shows that no current entity fully corresponds to manic fury as described by the early alienists, even if some pathologies share partial similarities. However, these modern diagnoses overlook the psychotic core that constituted the very essence of manic fury in the alienists’ writings. Likewise, bipolar disorders reduce manic fury to a simple mood elevation, while psychotic disorders require the presence of verbal delusions or hallucinations, without considering praxic delusion.

Manic fury is an ancient psychiatric concept, first described by early alienists who identified the pathological nature of certain violent acts driven by “praxic delusion” rather than ideational or verbal delusions. Initially expanded and later critiqued, the concept fragmented into multiple clinical entities. Simultaneously, the term reappeared in mood disorders to describe paroxysmal psychomotor agitation in some patients. This dual evolution stripped manic fury of its core psychotic nature. Clinical evidence suggests revisiting this diagnosis. Using an alternative term, such as “delusion of acts”, could separate it from bipolar disorder and reinstate it within chronic psychotic disorders.