This case indicates how difficult it is to distinguish the excitement seen in the Catatonic Type of Schizophrenia from that seen in a Manic Episode. This woman has many symptoms that suggest the manic syndrome. Her mood is described as alternately silly, cheerful, and irritable. There are pressure of speech (e.g., "She chatters continually, and will not let anyone get in a word") and hyperactivity (e.g., "she hops about, bends down, claps her hands"). She is also grandiose (e.g., "she looks on herself as the mistress of the house; she pays the nurses and appoints them") and sexually provocative.