Schizophrenia, schizoaffective disorder, bipolar disorder

2020 ◽  
pp. 38-45
Author(s):  
Barrett Kern ◽  
Sarah K. Keedy

Schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features include varying degrees of psychosis and mood symptoms. As such, these disorders may represent three points on a spectrum rather than three categorically distinct disorders. This chapter outlines the key role of psychosis in characterizing these disorders and reviews the conceptual history of this characterization as embodied in the different editions of the Diagnostic and Statistical Manual of Mental Disorders. The inherent practical and conceptual problems associated with a categorical system for these diagnoses and for defining psychosis symptoms are emphasized. Finally, specific symptoms and their qualitative and quantitative features are compared and contrasted among schizophrenia, schizoaffective disorder, and psychotic bipolar disorder.

2019 ◽  
Vol 64 (9) ◽  
pp. 607-610
Author(s):  
Gordon Parker

Schizoaffective disorder has long been recognized and quite variably defined. It has been variably positioned as a discrete entity, a variant of either schizophrenia or of a mood disorder, as simply reflecting the co-occurrence of schizophrenia and a mood disorder, and effectively reflecting a diagnosis along a continuum linking schizophrenia and bipolar disorder. This article considers historical views, some empirical data that advance consideration of its status, and focuses on its classification in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). DSM-5 criteria seemingly weight it in the direction of a schizophrenic illness, as do some empirical studies, whereas the empirical literature examining the response to lithium links it more closely to bipolar disorder. It is suggested that DSM-5’s B and C criteria are operationally unfeasible. Some suggestions are provided for a simpler definition.


2020 ◽  
Vol 9 (11) ◽  
pp. 3619
Author(s):  
Alessandra Alciati ◽  
Fabiola Atzeni ◽  
Daniela Caldirola ◽  
Giampaolo Perna ◽  
Piercarlo Sarzi-Puttini

About half of the patients with fibromyalgia (FM) had a lifetime major depression episode and one third had a panic disorder (PD). Because the co-morbidity between bipolar disorder (BD) and PD marks a specific subtype of BD we aimed to investigate if co-morbid BD/PD (comBD/PD) occurs more frequently than the single disorder in FM patients and evaluate the clinical significance and timing of this co-morbidity. Further, we explored the role of co-morbid subthreshold BD and PD. In 118 patients with FM, lifetime threshold and sub-threshold mood disorders and PD were diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) Clinical Interview. Demographic and clinical variables were compared in co-morbid BD/PD (comBD/PD) and not co-morbid BD/PD (nocomBD/PD) subgroups. The co-morbidity BD/PD was seen in 46.6% of FM patients and in 68.6% when patients with minor bipolar (MinBD) and sub-threshold panic were included. These rates are higher than those of the general population and BD outpatients. There were no statistically significant differences between threshold and sub-threshold comBD/PD and nocom-BD/PD subgroups in demographic and clinical parameters. In the majority of patients (78.2%), the onset of comBD/PD preceded or was contemporary with FM. These findings support the hypothesis that comBD/PD is related to the development of FM in a subgroup of patients.


Author(s):  
Hamzeh Hosseini ◽  
Neda Zamani ◽  
Amirhossein Ahmadi

Background:  Diplopia, or double vision, is a common ophthalmologic complaint with many underlying causes, ocular and neurological. Aripiprazole has been reported to have fewer adverse effects and better efficacy than other atypical antipsychotics. Although ocular side effects of aripiprazole are not remarkable, two cases of diplopia associated with aripiprazole have been reported in the literature. Objectives: Herein, we report the third case of diplopia, after the aripiprazole prescription in a woman with depressive disorder. Case Presentation: A 37-year-old woman was brought to our clinic with symptoms of sleep loss, displeasure, auditory hallucination, and pessimistic thoughts. After a clinical interview, the patient was diagnosed with depression with psychotic features according to the Diagnostic and Statistical Manual (DSM-V) of mental disorders. She underwent treatment with 15 mg/d aripiprazole and 20 mg/d fluoxetine. Her symptoms reduced after three months as indicated by the visual analog scale. However, the patient returned to the clinic and complained of double vision. Neither neurological nor ophthalmological problems were observed following examinations by specialists. When the dose of the drug decreased and eventually discontinued, diplopia disappeared over 24 hours. Conclusion: Since the patient had no history of diplopia and two cases of diplopia associated with aripiprazole were previously reported in the literature, we expected that the diplopia was related to the recently prescribed aripiprazole treatment. Physicians should be aware of the possible risk of diplopia-induced by aripiprazole and recommend patients discontinuing the drug immediately if complications have occurred.


2021 ◽  
pp. 000486742110200
Author(s):  
Gordon Parker

The 2020 College guidelines for mood disorders banish bipolar II disorder – despite its formal status in Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases manuals for more than two decades – and argue that there is no need to partition bipolar disorder into separate sub-types. Their single-entity model is seemingly based on opinion rather than any support from referenced scientific studies. The author challenges the Committee’s model of there being only one bipolar disorder and argues that it presents several clinical management risks, particularly of ‘over-treatment’.


2018 ◽  
Vol 52 (12) ◽  
pp. 1173-1182 ◽  
Author(s):  
Gordon Parker ◽  
Gabriela Tavella ◽  
Glenda Macqueen ◽  
Michael Berk ◽  
Heinz Grunze ◽  
...  

Objective: To derive new criteria sets for defining manic and hypomanic episodes (and thus for defining the bipolar I and II disorders), an international Task Force was assembled and termed AREDOC reflecting its role of Assessment, Revision and Evaluation of DSM and other Operational Criteria. This paper reports on the first phase of its deliberations and interim criteria recommendations. Method: The first stage of the process consisted of reviewing Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and recent International Classification of Diseases criteria, identifying their limitations and generating modified criteria sets for further in-depth consideration. Task Force members responded to recommendations for modifying criteria and from these the most problematic issues were identified. Results: Principal issues focussed on by Task Force members were how best to differentiate mania and hypomania, how to judge ‘impairment’ (both in and of itself and allowing that functioning may sometimes improve during hypomanic episodes) and concern that rejecting some criteria (e.g. an imposed duration period) might risk false-positive diagnoses of the bipolar disorders. Conclusion: This first-stage report summarises the clinical opinions of international experts in the diagnosis and management of the bipolar disorders, allowing readers to contemplate diagnostic parameters that may influence their clinical decisions. The findings meaningfully inform subsequent Task Force stages (involving a further commentary stage followed by an empirical study) that are expected to generate improved symptom criteria for diagnosing the bipolar I and II disorders with greater precision and to clarify whether they differ dimensionally or categorically.


CNS Spectrums ◽  
2003 ◽  
Vol 8 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Alan B. Douglass

AbstractDoes narcolepsy, a neurological disease, need to be considered when diagnosing major mental illness? Clinicians have reported cases of narcolepsy with prominent hypnagogic hallucinations that were mistakenly diagnosed as schizophrenia. In some bipolar disorder patients with narcolepsy, the HH resulted in their receiving a more severe diagnosis (ie, bipolar disorder with psychotic features or schizoaffective disorder). The role of narcolepsy in psychiatric patients has remained obscure and problematic, and it may be more prevalent than commonly believed. Classical narcolepsy patients display the clinical “tetrad”—cataplexy, hypnagogic hallucinations, daytime sleep attacks, and sleep paralysis. Over 85% also display the human leukocyte antigen marker DQB10602 (subset of DQ6). Since 1998, discoveries in neuroanatomy and neurophysiology have greatly advanced the understanding of narcolepsy, which involves a nearly total loss of the recently discovered orexin/hypocretin (hypocretin) neurons of the hypothalamus, likely by an autoimmune mechanism. Hypocretin neurons normally supply excitatory signals to brainstem nuclei producing norepinephrine, serotonin, histamine, and dopamine, with resultant suppression of sleep. They also project to basal forebrain areas and cortex. A literature review regarding the differential diagnosis of narcolepsy, affective disorder, and schizophrenia is presented. Furthermore, it is now possible to rule out classical narcolepsy in difficult psychiatric cases. Surprisingly, psychotic patients with narcolepsy will likely require stimulants to fully recover. Many conventional antipsychotic drugs would worsen their symptoms and make them appear to become a “chronic psychotic,” while in fact they can now be properly diagnosed and treated.


1993 ◽  
Vol 163 (S21) ◽  
pp. 20-26 ◽  
Author(s):  
M. T. Abou-Saleh

The search for predictors of outcome has not been particularly rewarding, and the use of lithium remains empirical: a trial of lithium is the most powerful predictor of outcome. However, lithium is a highly specific treatment for bipolar disorder. In non-bipolar affective disorder, factors of interest are correlates of bipolar disorder: mood-congruent psychotic features, retarded-endogenous profile, cyclothymic personality, positive family history of bipolar illness, periodicity, and normality between episodes of illness.


2020 ◽  
Author(s):  
Mulugeta Gobena Tadesse ◽  
Dereje Dirago Dire ◽  
Yacob Yacob Abraham

Abstract Background: Premenstrual dysphoric disorder (PMDD)-is a severe and disabling form of premenstrual Syndrome affecting 3-8% of menstruating women. The disorder consists of a cluster of affective, behavioral and somatic symptoms that recur monthly during the luteal phase the menstrual cycle. Premenstrual dysphoric disorder (PMDD) was added to the list of depressive disorders in the diagnostic and statistical manual of mental disorders in 2013. The exact pathogenesis of the disorder is still unclear.Objective: To assess the prevalence of PMDD and its associated factors among students of Hawassa tabor secondary and preparatory school.Method: A cross sectional institutional based was conducted among 351 randomly selected female students of Hawassa tabor school. Data was collected by three students were facilitate the works with closed ended structured questionnaire and they was trained on how to collect the data. The collected data was entered, analyzed and cleaned by SPS.Results: prevalence of premenstrual dysphoric disorder in this study was 76.9%. Of each symptom is more than ninety present or 324 (92.3%) respondents can’t have experience unpleasant physical or emotional symptoms peculiar to the five days before the onset of menses & 27(7.7%) participants have show the symptoms. Among those 26 (7.4%) have present for the past ≥3 consecutive cycles. 46 (13.1%) have family history of such symptoms.Conclusions: These findings have implications for both women and medical providers, who should be aware that PMS symptoms are prevalent and often distressing, yet also understand that the severity of symptoms may remit over time.


2018 ◽  
Author(s):  
F Gerard Moeller

There is a consistent body of evidence showing that substance abuse and dependence can worsen preexisting medical conditions, can temporarily mimic medical and psychiatric disorders, and can themselves cause medical problems, including life-threatening overdose. Substance use disorders are common in young and middle-aged persons: the lifetime prevalence of these syndromes, including alcoholism, is over 20% for men and about 15% for women. This chapter discusses dependence, abuse, substance use disorder, and substance-induced disorders involving depressants, stimulants, opioids, cannabinoids, hallucinogens, N-methyl-D-aspartate (NMDA) receptor channel blockers, and inhalants. Epidemiology, etiology, pathophysiology, diagnosis (including clinical assessment and laboratory tests), and treatment are reviewed. Treatment of intoxication, overdose, withdrawal, and rehabilitation is discussed. A figure illustrates the neurocircuitry of addiction. Tables describe the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) diagnostic criteria for abuse and dependence; frequently misused drugs; neural effects of commonly abused drugs; the natural history of drug dependence; conditions affecting the outcome of urinary drug tests; and pharmacologic options for treatment of drug overdose. This chapter contains 1 figure , 6 tables and 112 references


2003 ◽  
Vol 64 (4) ◽  
pp. 451-458 ◽  
Author(s):  
Antonio Ciapparelli ◽  
Liliana Dell'Osso ◽  
Adolfo Bandettini di Poggio ◽  
Claudia Carmassi ◽  
Donatella Cecconi ◽  
...  

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