Psychiatria Danubina, Vol. 29 No. 2, 2017.
Original scientific paper
MOOD SYMPTOMS IN STABILIZED PATIENTS WITH SCHIZOPHRENIA: A BIPOLAR TYPE WITH PREDOMINANT PSYCHOTIC FEATURES?
Konstantinos N. Fountoulakis
; 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
Dina Popovic
; Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel; Barcelona Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain
Mariela Mosheva
; Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Melina Siamouli
; School of Medicine, Aristotle University of Thessaloniki, Greece
Katerina Moutou
; Private practice, Volos, Greece
Xenia Gonda
; Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Semmelweis University, MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelw
Abstract
Background: Schizophrenia (SZ) and bipolar disorder (BD) are traditionally distinguished on the basis of progressive
deterioration and long-term outcome, but a more dimensional approach is warranted. There are limited data on the occurrence of
manic symptoms in patients with schizophrenia. The aim of the current study was to search for patterns in the clinical
symptomatology, which may suggest the presence of one or several mood disorders under the label of schizophrenia.
Subjects and methods: Hundred-seventy-five patients diagnosed with schizophrenia according to DSM-5 were included in the
study. The psychometric assessment included the Positive and Negative Syndrome Scale, Young Mania Rating Scale, The Montgomery-
Åsberg Depression Rating Scale and the Calgary Depression Scale. The statistical analysis included MANOVA, Pearson
Correlation coefficient and principal components analysis.
Results: Significant subthreshold manic symptoms were present in 25.14% of patients. Mood symptoms correlated with positive
symptoms. The PCA revealed a complex structure with 15 factors (one positive, negative, somatic, anxiety, neurocognitive, disorganization
and manic, five depressive and three psychomotor/excitement/hostility/violence).
Conclusion: Psychotic mood disorders are often phenotypically indistinguishable from schizophrenia, so it is likely that
psychotic affective patients have been misdiagnosed with schizophrenia. The current study suggests that there seem to be patients
with mania misdiagnosed as 'schizophrenics' because of the presence of psychotic features, a condition better described as
'schizophreniform bipolar disorder'.
Keywords
bipolar disorder; psychotic symptoms; psychosis
Hrčak ID:
184747
URI
Publication date:
28.6.2017.
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