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Objectives: Schizophrenia is a disorder with different clinical features. Schizophrenia may start insidiously and slow and go on for many years. But the negative symptoms and deficiency symptoms leading to social deterioration may come to the forefront. All these factors are taken into consideration, our aim in this study was to examine the demographic and clinical effects of symptoms on schizophrenic patients who have not yet been treated. Methods: Eighty patients who were admitted to the Ankara Numune Training and Research Hospital Psychiatry Outpatient Clinic, who did not have any previous antipsychotic medications and who did not use medications at the time of admission and who met the criteria for schizophrenia according to the DSM-5. Sociodemografic Data Form and the PANSS scale were used to assess the clinical status of the patients. Results: When the demographic characteristics of the participants were examined, 33 (41.2%) were female and 47 (58.8%) were male. The mean age of the patients was 31.08±9.37; mean education year was 8.76±3.53. When the patients participating in the study were evaluated in terms of gender, marital status, working status, smoking status, and family history, no statistical differences were found between the groups in terms of their PANSS scores (p>0.05). However, the PANSS Negative subscale scores (p<.001), general psychopathology scores (p=0.006), and total PANSS scores (p=0.003) were statistically significantly different between the three groups when the patients were untreated for 0-1 years, 1-5 years, and 5 years. Conclusions: In this study none of the sociodemographic factors we assessed had any effect on symptom severity. However, there are different results in the literature regarding gender, age, marital status and working status. Besides, it has been determined that the most important clinical manifestation in our study is the period without treatment. Further studies should identify demographic and clinical features that affect schizophrenic symptom changes.

Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode that emerges after the loss of a loved one. There are not many cases that associate causality of beginning of mania and mourning in the literature. It is known that mania is induced by traumatic events but the cases that do not suit stages of development of grief process are evaluated as pathological grief. In this case, the woman who experienced manic episode after her son's death is presented. This case is prepared because mania should be considered as possible grief reaction. Case presentation: A patient who is 40 years old, married, mother of 4 children is brought by relatives because of aggressiveness, tension, insomnia for 4 days, fast and talk a lot and nonsense laughing attacks. She was presented to hospital for stressful life events 2 years ago and started to be on medication (escitalopram 10 mg) because of depression and fibromiyaliji diagnosis. She used medication for 1.5 years and she did not use any medication for the last 6months. There is no history for mental disorder in her family. Psychological examination: her interest for the environment was increased, self-care ability got better, her temperament was cheerful, her sociability was respectful, amount of talking and tone of voice increased, mimic and gesture was appropriate for her temperament, sleeping decreased, thought flow increased and achieved goal of conversation late. Moreover, there were grandiose delusions and hypervigilance, affect was close to euphoria, her psychomotor behaviours increased and social functioning decreased. According to biochemical and radiological workup, there was no pathological situation. The client started to use Lithium 900 mg/day and Olanzapin 10 mg/day because of the bipolar disorder diagnosis. The patient's blood lithium level was 0.8mEq/L and lithium was used 1200 mg/day and then 10 days later the patient's blood lithium level was 0.72 mEq/L. According to clinical observations, the patient's manic symptoms remained. Furthermore, the patient started to cry occasionally after 1 month and her grandiosity disappeared. The patient was discharged from the hospital after 45 days. The patient met the criteria for manic episode in DSM 5. The patient did not take any medication for last 6 months. Thus, it is considered that this situation was not induced by medication. It puts the patient into risk group because she was treated for depression before but it is not considered as bipolar depression because there were psychiatric history in the family and depression that experienced 2 years ago was related to stressful life events. It is considered that this case experienced grief/funeral mania because there was contiguity between loss of her son and manic episode, the patient did not react this way to previous challenging life events and the patient was outside of the ordinary 5 stages of grief process.

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