Abstract
Abstract Introduction: In the last years there is a great interest for the theory of the “psychotic continuum”, which accepts that there is a transition between schizophrenia and affective pathology, including bipolar disorder with psychotic interferences and the recently introduced diagnosis of schizoaffective disorder. There are few studies that analyze bipolar disorder with mood-incongruent psychosis. The purpose of this study was to observe the way in which the interference of mood-incongruent psychotic symptoms can influence the long term evolution of patients diagnosed with bipolar disorder and the similarities that exists between this type of pathology and schizoaffective disorder. Material and methods: Sixty subjects were selected, who are now diagnosed with schizoaffective disorder and bipolar disorder, with and without psychotic features. All cases have at least 15 years of evolution since the first episode of psychosis and were analyzed in term of their age of onset and longitudinal evolution. Results: The results showed that bipolar patients who had mood incongruent psychotic symptoms had an earlier age of onset and a higher rate of hospitalizations in their long term evolution compared to bipolar patients without psychotic features, which brings them closer to patients with schizoaffective disorder in term of their pattern of evolution. Conclusions: This study has demonstrated that the interference of mood-incongruent psychosis with bipolar disorder determines a worse prognosis of this disease, very similar with the evolution of patients with schizoaffective disorder
Highlights
In the last years there is a great interest for the theory of the “psychotic continuum”, which accepts that there is a transition between schizophrenia and affective pathology, including bipolar disorder with psychotic interferences and the recently introduced diagnosis of schizoaffective disorder
In the last decades this approach has changed, with the development of many other clinical perspectives: envisaging psychopathological disorders not as clinical entities, but as subtypes of a spectrum, the progresses made in pharmacological therapy, neurobiology, genetics, in the theory of evolutionism and so on. This view modifies the understanding of the correlation between bipolar disorder and schizophrenia, or “psychoses” in general
International studies challenge the dichotomy between schizophrenia and bipolar disorder following the recent progress mainly in the field of genetics and neurobiology
Summary
In the last years there is a great interest for the theory of the “psychotic continuum”, which accepts that there is a transition between schizophrenia and affective pathology, including bipolar disorder with psychotic interferences and the recently introduced diagnosis of schizoaffective disorder. The purpose of this study was to observe the way in which the interference of mood-incongruent psychotic symptoms can influence the long term evolution of patients diagnosed with bipolar disorder and the similarities that exists between this type of pathology and schizoaffective disorder. In the last decades this approach has changed, with the development of many other clinical perspectives: envisaging psychopathological disorders not as clinical entities, but as subtypes of a spectrum, the progresses made in pharmacological therapy, neurobiology, genetics, in the theory of evolutionism and so on. This view modifies the understanding of the correlation between bipolar disorder and schizophrenia, or “psychoses” in general. Several lines of evidence suggest that patients with psychotic features in bipolar disorder are very similar to patients with schizophrenia in genetic and neurobiological respects and many psychopharmacologic interventions are effective in both disorders [1,2].
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