March 10, 2006

Schizophrenia is actually Bipolar Disorder?

Read more... Schizophrenia Biology

As we've covered previously - research has increasingly shown that bipolar disorder and schizophrenia are related in genetics studies, and the symptoms are really more of a continuum than discrete disorders (see Stanford University presentation on this topic from last summer)(presentation slides here).

Some researchers are suggesting that schizophrenia may just be another type of bipolar disorder. At some level I suspect it comes down to an issue of semantics - and ultimately doctors treat the symptoms.

In the recent issue of Current Psychiatry, they discusses this issue in the article titled "Schizophrenia is psychotic bipolar disorder? What a polarizing idea!"

In the commentary, the author states:

A hundred years ago, Kraepelin distinguished two types of “insanity” in his institutionalized patients: dementia praecox (later relabeled as schizophrenia) and manic-depressive illness (later relabeled as bipolar disorder. His dichotomy was based on differences in clinical features, course, and outcomes. But over the years, Kraepelin recognized and admitted that some patients have overlapping features, and he gradually accepted what is now seen as a continuum of psychosis that “bridges” the pure forms of those two disorders.

I applaud Drs. Lake and Hurwitz for highlighting the diagnostic and treatment errors in a bipolar patient with severe psychotic features who was misdiagnosed as having schizophrenia. Errors such as this were common with DSM I and II but declined with the more reliable diagnostic schemas of DSM III and IV. I am puzzled, however, by their leap to the radical conclusion that schizophrenia does not exist and that all patients diagnosed with schizophrenia have psychotic bipolar disorder. This is not as egregious as Szasz’ absurd proclamation 4 decades ago that schizophrenia is a “myth,” but it is a significant scientific “transgression,” given the evidence that distinguishes schizophrenia from bipolar disorder.

Read the full article here: Schizophrenia is psychotic bipolar disorder?


I work with chronically mentally ill and have noted that many consumers are labeled "Schizoaffective" with a secondary bipolar diagnosis. So your article makes a lot of sense. I do note many of the same symptoms in both Schizophrenia and Bipolar (with a psychotic break). I think that mental health is so subjective. The diagnosis of a person can drastically change from psychiatrist to psychiatrist. And all disorders stem from similar chemical embalances in the brain.

Posted by: Rachelle at March 12, 2006 09:00 AM

These symptoms are treated with totally different medications, although there seems to have come more overlap with the anti-convulsant medications for (schizotypical) bipolar disorder.

Point is: the genetics for both schizophrenia and manic depression are still far from clear, and while these are sought out it makes sense not to define them as all too different, and to seek for overlap in the genes.

Posted by: freeZotic at March 12, 2006 12:45 PM

The intro to this article reads: "Some researchers are suggesting that schizophrenia may just be another type of schizophrenia."

I just cut and pasted what was written. Either some researchers are totally stupid or the writer of this intro needs to proof read his\her writing... How can Schizophrenia "be another type of schizophrenia"?

Are you following me or do I need to repeat it again?


Posted by: Mister at March 17, 2006 07:53 PM

I think the illnesses are similar, but not the same. I also think there are people who have varying degrees of mixtures of the two illnesses. i have known families in which several people had mental illness, and it is not to me unusual to find people in one family, one diagnosed with bipolar, one diagnosed with schizophrenia, and one diagnosed with schizoaffective disorder. however, i still find that there are differences at least in the downstream biochemistry of the two illnesses (since we don't know the upstream chemistry, ie, the causes), and in the outcomes, patterns of symptoms and epidemiology of the diseases. for me, that is ample evidence that there is at least some difference between the two diseases. that several people in a family may be diagnosed with bipolar and schizophrenia is still nothing to base a lot of assumptions on - when i know the cause, i'll know how valid their statements are. first the cause, then the rest, not the other way around.


Posted by: slc at April 10, 2006 04:18 PM

I take medication for both schizophrenia and bipolar disorder, so this article made sense to me. My psychiatrist diagnosed me as being schizophrenic with bipolar tendencies, so I agree with this article.

Posted by: Amy at April 24, 2006 05:49 AM

Familial probands in schizoaffective disorders is a reality. Such can be the case with breast cancer or any genetic trait that "expresses itself" in a family. However if you have breast cancer you must treat or perish. That is not the case with bipolar or schizphrenia. My two year experience allowed for upclose study of cousins, both mother's were sisters and had a common father, were the expression on one cousin was schizophrenia and the other bipolar, both with pyschotic breaks. The one cousin with the schizophrenia was being treated, the other refused or her therapist did not recommend treatment. Both mother's expressed bipolar symptoms. The grandfather of the cousins had also bipolar expression. He vanished for months, turning up after another man had been buried in his name. One of the daughters opened her door and sreamed, "your suppose to be dead." The family has struggled for years, I don't think anyone has broken the truth about the familial proband of this disease of the mind.

Posted by: john bocchetti at June 29, 2007 04:20 PM

It's interesting to me that many of you have poor writing skills. My next research project is to find out if these disorders cause dysgraphia.

Posted by: Terrence Ketter at June 11, 2008 10:37 PM

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