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The factor that is most commonly not a characteristic of mania associated with adrenal insufficiency is persistent hallucinations. Mania is typically characterized by symptoms such as elevated mood, increased energy, and impulsivity, which reflect hyperactivity and heightened emotional states. These symptoms align with the manic presentation seen in mood disorders, including those that may arise in the context of an underlying medical condition like adrenal insufficiency.

Adrenal insufficiency can lead to mood disturbances, including irritability or depressive symptoms, rather than classic manic symptoms when linked to hallucinatory experiences. Persistent hallucinations are more indicative of other psychiatric disorders, such as schizophrenia, or could arise from severe intoxication, substance use, or specific neurologic conditions, rather than being a standard feature of mania secondary to adrenal insufficiency. This hallmark serves to differentiate types of psychiatric presentations and assists clinicians in targeting appropriate diagnostic and treatment strategies.