L Tondo1,2, G H Vázquez1,3, C Baethge4, C Baronessa5, L Bolzani5, A Koukopoulos6,7, L Mazzarini6, A Murru8, I Pacchiarotti8, M Pinna2, P Salvatore1,9, G Sani6,7, V Selle5, G Spalletta10,11, P Girardi6,7, M Tohen12, E Vieta8, R J Baldessarini1. 1. Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA. 2. Lucio Bini Mood Disorder Center, Cagliari, Italy. 3. Department of Neuroscience, Palermo University, Buenos Aires, Argentina. 4. Department of Psychiatry, University of Köln, Köln, Germany. 5. Viarnetto Psychiatric Clinic, Lugano, Switzerland. 6. NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy. 7. Lucio Bini Mood Disorder Center, Rome, Italy. 8. Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain. 9. Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy. 10. Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy. 11. Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. 12. Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA.
Abstract
OBJECTIVE: Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD: We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS: In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION: SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.
OBJECTIVE: Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD: We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS: In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION: SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.
Authors: Stephanie A Rolin; Kelly A Aschbrenner; Karen L Whiteman; Emily Scherer; Stephen J Bartels Journal: Am J Geriatr Psychiatry Date: 2017-04-03 Impact factor: 4.105
Authors: Alison K Merikangas; Lihong Cui; Monica E Calkins; Tyler M Moore; Ruben C Gur; Raquel E Gur; Kathleen R Merikangas Journal: J Affect Disord Date: 2017-03-10 Impact factor: 4.839
Authors: Tyler B Grove; Beier Yao; Savanna A Mueller; Merranda McLaughlin; Vicki L Ellingrod; Melvin G McInnis; Stephan F Taylor; Patricia J Deldin; Ivy F Tso Journal: Psychiatry Res Date: 2018-05-07 Impact factor: 3.222
Authors: Kathryn Eve Lewandowski; Sarah H Sperry; Dost Ongur; Bruce M Cohen; Lesley A Norris; Matcheri S Keshavan Journal: Trials Date: 2016-03-12 Impact factor: 2.279