TY - JOUR
T1 - A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia
T2 - The Schizo-Bipolar Scale
AU - Keshavan, Matcheri S.
AU - Morris, David W.
AU - Sweeney, John A.
AU - Pearlson, Godfrey
AU - Thaker, Gunvant
AU - Seidman, Larry J.
AU - Eack, Shaun M.
AU - Tamminga, Carol
N1 - Funding Information:
This study was supported in part by NIMH grants MH 78113 (MSK); R01 MH077945 (Pearlson) MH 77852 (Thaker), MH 77851 (CT), MH077862 (JS) and KL2 RR024154 (SME).
PY - 2011/12
Y1 - 2011/12
N2 - Background: There is increasing evidence for phenomenological, biological and genetic overlap between schizophrenia and bipolar disorder, bringing into question the traditional dichotomy between them. Neurobiological models linked to dimensional clinical data may provide a better foundation to represent diagnostic variation in neuropsychiatric disorders. Method: To capture the interaction between psychosis and affective symptoms dimensionally, we devised a brief descriptive scale based on the type and relative proportions of psychotic and affective symptoms over the illness course. The scale was administered to a series of 762 patients with psychotic disorders, including schizophrenia, schizoaffective and psychotic bipolar disorder assessed as part of the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) study. Results: The resulting Schizo-Bipolar Scale scores across these disorders showed neither a clear dichotomy nor a simple continuous distribution. While the majority of cases had ratings close to prototypic schizophrenia or bipolar disorder, a large group (45% of cases) fell on the continuum between these two prototypes. Conclusions: Our data suggest a hybrid conceptualization model with a representation of cases with prototypic schizophrenia or bipolar disorder at the extremes, but a large group of patients on the continuum between them that traditionally would be considered schizoaffective. A dimensional approach, using the Schizo-Bipolar Scale, characterized patients across a spectrum of psychopathology. This scale may provide a valuable means to examine the relationships between schizophrenia and psychotic bipolar disorder.
AB - Background: There is increasing evidence for phenomenological, biological and genetic overlap between schizophrenia and bipolar disorder, bringing into question the traditional dichotomy between them. Neurobiological models linked to dimensional clinical data may provide a better foundation to represent diagnostic variation in neuropsychiatric disorders. Method: To capture the interaction between psychosis and affective symptoms dimensionally, we devised a brief descriptive scale based on the type and relative proportions of psychotic and affective symptoms over the illness course. The scale was administered to a series of 762 patients with psychotic disorders, including schizophrenia, schizoaffective and psychotic bipolar disorder assessed as part of the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) study. Results: The resulting Schizo-Bipolar Scale scores across these disorders showed neither a clear dichotomy nor a simple continuous distribution. While the majority of cases had ratings close to prototypic schizophrenia or bipolar disorder, a large group (45% of cases) fell on the continuum between these two prototypes. Conclusions: Our data suggest a hybrid conceptualization model with a representation of cases with prototypic schizophrenia or bipolar disorder at the extremes, but a large group of patients on the continuum between them that traditionally would be considered schizoaffective. A dimensional approach, using the Schizo-Bipolar Scale, characterized patients across a spectrum of psychopathology. This scale may provide a valuable means to examine the relationships between schizophrenia and psychotic bipolar disorder.
KW - Bipolar disorder
KW - Continuum
KW - Schizoaffective disorder
KW - Schizophrenia
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U2 - 10.1016/j.schres.2011.09.005
DO - 10.1016/j.schres.2011.09.005
M3 - Article
C2 - 21996268
AN - SCOPUS:81955164813
SN - 0920-9964
VL - 133
SP - 250
EP - 254
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-3
ER -