The study investigates the prevalence, clinical characteristics, and implications of catatonic symptoms in mania. Sixty-one inpatients with DSM-III-R bipolar disorder (BD), manic or mixed episode, established by the Structured Clinical Interview for DSM-III-R (SCID) were assessed for the presence of catatonic by a 21-item rating scale. Nineteen patients fulfilled criteria for catatonic mania, exhibiting between five and 16 catatonic symptoms. Catatonic manics had more mixed episodes, more severe manic symptoms, more general psychopathology, a higher prevalence of comorbidity, a longer hospitalization, and lower Global Assessment of Functioning (GAF) scores than the noncatatonics. The results indicate that catatonic symptoms are a marker of a more severe course and outcome in mania.