Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-06-05T14:59:08.943Z Has data issue: false hasContentIssue false
  • English
  • Français

Cross-sectional similarities and differences between schizophrenia, schizoaffective disorder and mania or mixed mania with mood-incongruent psychotic features

Published online by Cambridge University Press:  16 April 2020

Stefano Pini ,
Valeria de Queiroz ,
Liliana Dell'Osso ,
Marianna Abelli ,
Concettina Mastrocinque ,
Marco Saettoni ,
Mario Catena  and
Giovanni B. Cassano
Stefano Pini*
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Valeria de Queiroz
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Liliana Dell'Osso
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Marianna Abelli
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Concettina Mastrocinque
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Marco Saettoni
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Mario Catena
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Giovanni B. Cassano
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
*
*Corresponding author. E-mail address:s.pini@psico.med.unipi.it (S. Pini).
Get access

Abstract

Background. – The cross-sectional clinical differentiation of schizophrenia or schizoaffective disorder from mood-incongruent psychotic mania or mixed mania is difficult, since pathognomonic symptoms are lacking in these conditions.

Aims of the study. – To compare a series of clinical variables related to mood and cognition in patient groups with DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, mood-incongruent psychotic mania and mood-incongruent psychotic mixed mania.

Methods. – One hundred and fifty-one consecutive patients were evaluated in the week prior to discharge by using the structured clinical interview for DSM-III-R-patient edition (SCID-P). Severity of psychopathology was assessed by the 18-item version of the brief psychiatric rating scale (BPRS) and negative symptoms by the scale for assessment of negative symptoms (SANS). Level of insight was assessed with the scale to assess unawareness of mental disorders (SUMD).

Results. – There were no differences in rates of specific types of delusions and hallucinations between subjects with schizophrenia, schizoaffective disorder, psychotic mania and psychotic mixed mania. SANS factors scores were significantly higher in patients with schizophrenia than in the bipolar groups. Patients with mixed state scored significantly higher on depression and excitement compared to schizophrenia group and, to a lesser extent, to schizoaffective group. Subjects with schizophrenia showed highest scores on the SUMD indicating that they were much more compromised on the insight dimension than subjects with psychotic mania or mixed mania.

Conclusion. – Negative rather than affective symptomatology may be a useful construct to differentiate between schizophrenia or schizoaffective disorders from mood-incongruent psychotic mania or mixed mania.

Keywords

Mood-incongruent psychotic featuresManiaBipolar disorderSchizophreniaAwareness of illness
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 1 , January 2004 , pp. 8 - 14
Copyright
Copyright © 2003 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, HSPuzantian, VR. Psychotic forms of depression and mania. Psychiatr Clin North Am 1979;2:419–39.Google Scholar
Akiskal, HSBourgeois, MLAngst, JPost, RMoller, HJHirschfeld, R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Discord 2000;59:S5–S30.Google ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Press; 1994. p. 378–81.Google Scholar
Akiskal, HS. The temperamental borders of affective disorders. Acta Psychiatr Scand Suppl 1994;379:32–7.Google ScholarPubMed
Amador, XFStrauss, DHYale, SAFlaum, MMEndicott, JGorman, JM. Scale to assess unawareness of a mental disorder. Assessment of insight in psychosis. Am J Psychiatry 1993;150:873–9.Google ScholarPubMed
Amador, XFFlaum, MichaelAndreasen, NCStraus, DHYale, SAClark, SCet al. Awareness of illness in schizophrenia and schizoaffective and mood disorders. Arch Gen Psychiatry 1994;51:826–36.Google ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, rev. 3rd ed. Washington, DC: American Psychiatric Press; 1987.Google Scholar
Andreasen, NC. Negative symptoms predictive of schizophrenia: definition and reliability. Arch Gen Psychiatry 1982;39:784–9.Google Scholar
Andreasen, NCAkiskal, HS. The specificity of Bleulerian and Schneiderian symptoms: a critical reevaluation. Psychiatr Clin North Am 1983;6:41–54.Google ScholarPubMed
Atre-Vaidya, NTaylor, AM. Differences in prevalence of psychosensory features among schizophrenic, schizoaffective, and maniac patients. Compr Psychiatry 1997;38:88–92.Google Scholar
Azorin, JMPupeschi, GValli, MJoanny, PRaocules, DLancon, Cet al. Plasma 3-methoxy-4-hydroxyphenylglycol in manic patients: relationships with clinical variables. Acta Psychiatr Scand 1990;81:14–8.Google ScholarPubMed
Bunney, WGoodwin, FKMurphy, DL. The switch process in manic-depressive illness. Arch Gen Psychiatry 1972;27:295–1217.Google ScholarPubMed
Benabarre, AVieta, EColom, FMartinez-Aran, AReinares, MGasto, C. Bipolar disorder, schizoaffective disorder and schizophrenia: epidemiologic, clinical and prognostic differences. Eur Psychiatry 2001;16:167–72.Google ScholarPubMed
Cassano, GBPini, SSaettoni, MRucci, PDell'Osso, L. Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders. J Clin Psychiatry 1998;59:60–8.Google ScholarPubMed
Cassidy, FMcEvoy, JPYang, YKWilson, WH. Insight is greater in mixed than in pure manic episodes of bipolar I disorder. J Nerv Ment Dis 2001;189(6):398–9.Google ScholarPubMed
Coryell, WEndicott, JKeller, M. Rapidly cycling affective disorder. Demographics, diagnosis, family history, and course. Arch Gen Psychiatry 1992;49:126–31.Google ScholarPubMed
Dilsaver, SCChen, YWSwann, ACShoaib, AMTsai-Dilsaver, YKrajewski, KJ. Suicidality, panic disorder and psychosis in bipolar depression, depressive-mania and pure-mania. Psychiatry Res 1997;14:47–56.Google Scholar
Dayer, AAubry, JMRoth, LDucrey, SBertschy, G. A theoretical reappraisal of mixed states: dysphoria as a third dimension. Bipolar Disord 2000;2:316–24.Google ScholarPubMed
Dell'Osso, LAkiskal, HSFreer, PBarberini, MPlacidi, GFCassano, GB. Psychotic and non psychotic bipolar mixed states: comparisons with manic and schizoaffective disorders. Eur Arch Psychiatry Clin Neurosci 1993;243:75–81.Google ScholarPubMed
Dell'Osso, LPini, STundo, ASarno, NMusetti, LCassano, GB. Clinical characteristics of mania, mixed mania, and bipolar depression with psychotic features. Compr Psychiatry 2000;41:242–7.Google ScholarPubMed
Dell'Osso, LPini, SCassano, GBMastrocinque, CSeckinger, RASaettoni, Met al. Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features. Bipolar Disord 2002;4(5):315–22.Google ScholarPubMed
Endicott, JSpitzer, RLFleiss, JLCohen, J. The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976;33:766–71.Google ScholarPubMed
Freeman, MPMcElroy, SL. Clinical picture and etiologic models of mixed states. Psychiatr Clin North Am 1999;22:535–46.Google ScholarPubMed
Galynker, IIeronimo, CPerez-Acquino, ALee, YWinston, A. Panic attacks with psychotic features. J Clin Psychiatry 1996;57:402–6.Google ScholarPubMed
Haberman, SJ. Analysis of qualitative data, vol. 1. London: Academic Press; 1978.Google Scholar
Mackinnon, DFMcMahahon, FJSimpson, SGet al. Panic disorder with familial bipolar disorder. Biol Psychiatry 1997;42:90–5.Google ScholarPubMed
McElroy, SLKeck, PEPope, HGIHudson, JIFaedda, GLSwann, AC. Clinical and research implication of the diagnosis of dysphoric or mixed mania or hypomania. Am J Psychiatry 1992;149:1633–44.Google ScholarPubMed
Overall, JEGorham, DR. The brief psychiatric rating scale. Psychol Rep 1962;10:799.10.2466/pr0.1962.10.3.799CrossRefGoogle Scholar
Pini, SCassano, GBDell'Osso, LAmador, XF. Insight into illness in schizophrenia, schizoaffective disorder, and mood disorders with psychotic features. Am J Psychiatry 2001;158:122–5.CrossRefGoogle ScholarPubMed
Pini, SCassano, GBSimonini, ESavino, MRusso, AMontgomery, SA. Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia. J Affect Disord 1997;42:145–53.CrossRefGoogle ScholarPubMed
Pini, SDell'Osso, LMastrocinque, CMarcacci, GPapasogli, AVignoli, Set al. Axis I comorbidity in bipolar disorder with psychotic features. Br J Psychiatry 1999;175:467–71.10.1192/bjp.175.5.467CrossRefGoogle ScholarPubMed
Pitchot, WAnsseau, MGonzales Moreno, AHansenne, Mvon Frenckell, R. Dopaminergic function in panic disorder: comparison with major and minor depression. Biol Psychiatry 1992;32:1004–11.10.1016/0006-3223(92)90061-4CrossRefGoogle ScholarPubMed
Pope, HGLipinski, JF. Diagnosis in schizophrenia and manic-depressive illness: a reassessment of the specificity of schizophrenic symptoms in the light of current research. Arch Gen Psychiatry 1978;35:811–28.10.1001/archpsyc.1978.01770310017001CrossRefGoogle ScholarPubMed
Reddy, RMukherjee, SSchnur, DB. Comparison of negative symptoms in schizophrenic and poor outcome bipolar patients. Psychol Med 1992;22:361–5.CrossRefGoogle ScholarPubMed
Rossi, ADaneluzzo, EArduini, LDi Domenico, MStratta, PPetruzzi, C. Cognitive symptoms of mania in pure and mixed episodes evaluated with the positive and negative syndrome scale. Eur Arch Psychiatry Clin Neurosci 2000;250:254–6.CrossRefGoogle ScholarPubMed
Sax, KWStrakowski, SMMcElroy, SLKeck, SA JrWest, PE. Attention and formal thought disorder in mixed and pure mania. Biol Psychiatry 1995;37:420–3.10.1016/0006-3223(95)00310-DCrossRefGoogle ScholarPubMed
Schurhoff, FBellivier, FJouvent, RMouren-Simeoni, MCBouvard, MAllilaire, JFet al. Early and late onset bipolar disorders: two different forms of manic-depressive illness?. J Affect Disord 2000;58:215–21.CrossRefGoogle ScholarPubMed
Shoiab, AMDilsaver, SC. Panic disorder in subjects with pure mania and depressive mania. Anxiety 1995;1:302–4.CrossRefGoogle Scholar
Solovay, MRShenton, MEHolzman, PS. Comparative studies of thought disorders I: mania and schizophrenia. Arch Gen Psychiatr 1987;44:13–20.CrossRefGoogle Scholar
Spitzer, RLWilliams, JBWGibbon, M. Instruction manual for the structured clinical interview for DSM-III-R (SCID 4/1787 revision). Biometrics Research Department, New York State Psychiatric Institute; 1987.Google Scholar
SPSS Version 10.0 for Windows. Chicago, IL: SPSS Inc; 1999.Google Scholar
Taylor, MAAbrams, R. The phenomenology of mania: a new look at some old patients. Arch Gen Psychiatry 1973;30:520–2.CrossRefGoogle Scholar
Weiler, MAFleisher, MHMcArthur-Campbell, D. Insight and symptom change in schizophrenia and other disorders. Schizophr Res 2000;45:29–36.CrossRefGoogle ScholarPubMed
Yehuda, RSouthwick, SGiller, ELMa, XMason, JW. Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. J Nerv Ment Dis 1992;180:321–5.10.1097/00005053-199205000-00006CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.