Mixed states and schizophrenia

L'Encéphale
E FakraJ-M Azorin

Abstract

Because of their compilation of contrasted symptoms and their variable clinical presentation, mixed episodes have been withdrawn from the DSM. However, mixed states question not only the bonds between depression and mania, but also the distinction between bipolar disorders and schizophrenia. Indeed, doubts about the dichotomy introduced by Kraepelin between bipolar disorders and schizophrenia is as old as the nosolgy itself, as attest the later works of this author revealing his hesitations on his own classification. But findings here reviewed issued from recent technical advances, particularly in the imaging and genetic fields, offer a better understanding of the boundaries between these two disorders. Yet, when confronted to an acute episode, clinicians may find it challenging to distinguish a mixed state from a schizophrenic relapse. Indeed, there is no pathognomonic manifestation allowing to retain a diagnosis with confidence. The physician will therefore have to identify a pattern of signs, which will orient his assessment with no certainty. Thus, negative rather than affective or psychotic symptomatology appears to be useful in discriminating schizophrenia (or schizoaffective) disorders from mixed mania. However, a conclu...Continue Reading

References

Sep 9, 2000·Schizophrenia Research·M A WeilerD McArthur-Campbell
Mar 24, 2004·Schizophrenia Research·Jon McClellanChris McCurry
May 9, 2006·Journal of Affective Disorders·Lucy J RobinsonP Brian Moore
May 3, 2008·The Journal of Clinical Investigation·Teri A ManolioFrancis S Collins
Aug 5, 2008·Nature Genetics·Michael C O'DonovanUNKNOWN Molecular Genetics of Schizophrenia Collaboration
Jan 15, 2010·Schizophrenia Research·Ian Ellison-Wright, Ed Bullmore
Aug 13, 2011·Nordic Journal of Psychiatry·David MisdrahiPierre-Michel Llorca
May 29, 2012·Bipolar Disorders·Heather C WhalleyAndrew M McIntosh

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