What Is The Difference Between Bipolar With Psychotic Features And Schizoaffective Disorder
Schizoaffective Disorder is often confused with Bipolar Disorder with psychotic features. Both diagnosis include mood changes that impact life as well as symptoms of psychosis. A person diagnosed with Schizoaffective Disorder primarily experiences symptoms of psychosis even if mood problems dont exist.
When Does Ocd Turn Into Psychosis
A person who is considered to have OCD with poor or absent insight might not be able to acknowledge their thoughts and behaviors as problematic or unreasonable. This can be seen as a mental illness. When symptoms of psychosis can be seen, its when theres poor insight.
How Does A Psychiatrist Or Psychologist Diagnose Schizoaffective Disorder
Mental health professionals use specially designed interview and assessment tools to diagnose psychotic disorders. They listen to the person describe the symptoms. They also watch the persons speech, movement and behavior.
Providers figure out if these symptoms and behaviors match a specific disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . The American Psychiatric Association publishes the DSM-5. Its considered the reference book for mental health conditions.
According to the DSM-5, a person has schizoaffective disorder if they have:
- Periods of uninterrupted mental illness, such as having symptoms of depression or another mood disorder for a long time.
- Episode of mania, major depression or both while also having symptoms of schizophrenia.
- At least two weeks of psychotic symptoms without mood symptoms.
- No evidence of a substance use disorder or medications that may be causing the symptoms.
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Could My Bipolar Brother Develop Schizophrenia
Asked by Benjamin, St. Catharines, Ontario
I was wondering if my brother, who we have been told is bipolar, could develop schizophrenia? My uncle, my moms brother, was schizophrenic and unfortunately fell victim to the mental illness. We are aware that there have been some mental health issues with males on my mothers side of the family, so could it be possible that he could be schizophrenic as well as bipolar?
Mental Health ExpertDr. Charles RaisonPsychiatrist,Emory University Medical School
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Comparison Of Bipolar Disorder And Schizophrenia
Both schizophrenia and bipolar disorder are characterized as psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders fifth edition . Schizophrenia is a primary psychotic disorder, and bipolar disorder is a primary mood disorder but can also involve psychosis. However, because of some similar symptoms, differentiating between the two can sometimes be difficult indeed, there is an intermediate diagnosis termed schizoaffective disorder.
While reported and observed symptoms are a main way to diagnose either disorder, studies in the 21st century have allowed psychiatrists to use magnetic resonance imaging scans to try to find better, definite markers. Through MRIs, psychiatrists can see specific structural differences in the brains of people with schizophrenia. These differences include volume of gray matter, neuropathological size differences variations and cortical thickness, which are associated with cognitive differences on tests. These differences may sometimes be seen throughout the lifespan of the diseases and often occur soon after the initial episode. Although the diseases are different, some of their treatments are similar, because of some shared symptoms.
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Metabolic Syndrome: Culprit Accomplice Or Bystander
Patients with both schizophrenia and depression are at an increased risk for components of metabolic syndrome, including obesity, hypertension, atherogenic dyslipidemia, hyperglycemia, and diabetes . Metabolic syndrome in schizophrenia patients can be partially explained as a side-effect of antipsychotic medications . Nevertheless, a common mechanism between these conditions is hinted at by the db/db, Csmd1, and NPY models . Research linking metabolic syndrome and mental illness is still relatively new. Systemic inflammation and immune activation are features of schizophrenia, depression, and metabolic syndrome . Hence, immune dysregulation could be a causal factor in all three disorders. This is supported by fact that knocking out the immune molecule Csmd1 led to the development of glucose tolerance as well as schizophrenia and depression endophenotypes in mice . Alternatively, disruptions in systems such as leptin and NPY, which are involved in hunger and satiety, may cause schizophrenia and depression, while simultaneously predisposing patients of these disorders to behavioral risk factors for metabolic syndrome such as poor diet and sedentary lifestyle.
Symptoms Of Schizoaffective Disorder
The symptoms may vary greatly from one person to the next and may be mild or severe. They may include:
- Depression symptoms
- Hallucinations
- Lack of personal care
- Mania or sudden, out-of-character jumps in energy levels or happiness, racing thoughts, or risky behavior
- Problems with speech and communication, only giving partial answers to questions or giving answers that are unrelated
- Problems with speech and communication, only giving partial answers to questions, or giving answers that are unrelated.
- Trouble at work, school, or in social settings
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Schizophrenia Is Far Worse Than Just Hallucinations And Delusions
Schizophrenia is a misunderstood and often underestimated mental illness. It is a lifelong battle which devastates not only patients, but families and support systems who struggle to assist with maintenance of stability and functionality. Movies and television still confuse it with Dissociative Identity Disorder , and it is most often noted for its psychotic symptoms of paranoia, hallucinations, and false beliefs . However, hallucinations and delusions make up only part of the diseases symptoms.
Those positive symptoms of the disease, so named because they are experienced by people with Schizophrenia, but not by those who are typically functioning, comprise only a fraction of the illness. Prevalent in the internal experiences of a person living with Schizophrenia is another group of less obvious symptoms which diminish functioning and are resistant to treatment by antipsychotic medications. While those symptoms might be less obvious to the casual observer, they are no less pervasive or debilitating.
The term negative symptoms refers to traits which result from diminished personality characteristics existent in patients prior to onset of illness. These are symptoms which minimize functioning, and snuff out capacity to perform activities of daily living. They are also more likely to vex support systems because negative symptoms impair relationships through inhibited social skills.
Negative symptoms may be referred to as the Four As of Schizophrenia, and are as follows:
What Are The Types Of Schizoaffective Disorder
There are two types of schizoaffective disorder: bipolar schizoaffective disorder and depressive schizoaffective disorder. The two types are based on the associated mood disorder the person has:
- Bipolar disorder type: This condition features one or two types of different mood changes. People with bipolar disorder have severe highs alone or combined with lows .
- Depressive type: People who have depression have feelings of sadness, worthlessness and hopelessness. They may have suicidal thoughts. They may also experience concentration and memory problems.
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Can Bipolar Turn To Schizophrenia
Some mental illnesses share identical symptoms, such as mood swings and depression. Such overlaps occur in bipolar disorder and schizophrenia, sometimes making it difficult to differentiate between the two. However, these conditions are distinct from one another, and they do not always co-occur.
While bipolar disorder cannot develop into schizophrenia, its possible to experience symptoms of both. Before you consult a mental health professional, here are a few things you should know about the two conditions.
Connectivity Is The Key
Disruptions in processes related to brain connectivity are a common theme among the many of the models outlined here. Almost all of the models mentioned demonstrate links to synaptic processes such as synapse formation, regulation, and plasticity. Pdlim5, GluD1, reelin, Disc1, Kalrn, and social isolation affect synaptic spine morphology and/or formation, and GSK-3, Disc1, and reelin affect synaptic plasticity . Dynamic changes in synaptic spine morphology and formation, both developmentally during the establishment of neuronal circuits and as the result of activity or experience-dependent remodeling of existing circuits, are thought to be intimately linked to cognitive development and function . Disruptions in neurodevelopment may also interfere with brain connectivity through the miswiring of neuronal circuits. Disc1 and reelin are both important for neuronal migration and the formation of cortex layers, and PDE4B is involved in axon guidance and dendritic growth . Miswiring of neuronal circuits, whether at the level of brain structure from abnormal neurodevelopment or from dysregulation at the level of the synapse, possibly cause maladaptive alterations in brain connectivity leading to altered stimulus processing and cognition. This may be a common mechanism underlying the cognitive and behavioral symptoms of both schizophrenia and depression.
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Understanding The Link Between Schizophrenia And Depression
Schizophrenia and depression are brain disorders that, when tacked together, can create difficulties in finding the right treatments to tackle these complex disorders. Luckily, Banks Apothecary has the right treatment options available.
The prevalence of depressive disorder as a dual diagnosis with schizophrenia is high ranging up to 60% when schizophrenia is in its full-blown acute stage. These illnesses often overlap, so understanding these common types of co-occurring mental health disorders will help patients and their caregivers cope with the challenges they bring.
When trying to understand the link between schizophrenia and depression, there are a few questions to address:
- What is Schizophrenia?
- How Does Depression Affect Schizophrenia?
- What Are the Links Between These Two Diseases?
- What Kinds of Treatments Are Available for Schizophrenia and Depression?
Cub And Sushi Multiple Domains 1
Human genetic studies have found significant links between CSMD1 and schizophrenia, with nominally significant links reported for depression and bipolar disorder . Furthermore, risk variants in CSMD1 were shown to have effects on cognition and brain activation in healthy participants . CUB and SUSHI multiple domains 1 is a complement control-related protein that inhibits C3 in vitro . Complement is tightly regulated in the CNS as it is involved in microglia-dependent synaptic pruning and phagocytosis. For this reason, it is hypothesized that CSMD1 could play a role in aberrant synaptic elimination in neurodegenerative disorders . Hence, both immune and synaptic regulation may mediate the effects of Csmd1 in the development of both schizophrenia and depression-related phenotypes.
Steen et al. generated a Csmd1 knockout by deleting a 1 kb sequence from exon/intron1 . These mice developed an anxiety-like phenotype in the open field test and elevated plus maze . The mice also had increased exploratory activity in the novel object recognition test . However, this did not affect working memory, recognition, or preference, so it may simply be a reflection of increased anxiety. The mice had a potential depression-like phenotype in the TST, but no changes were seen in PPI. Finally, the KO mice had a significant increase in body weight accumulation over time, and increased glucose tolerance.
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Where Do I Go For Help
If youre not sure where to get help, your doctor, pediatrician, or other family health care provider is a good place to start. A health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating bipolar disorder and can evaluate your childs symptoms.
What If I Am A Carer Friend Or Relative
What support can I get?
You can get support if you care for someone with schizoaffective disorder. These are some options for you:
- Family Intervention through the NHS
- Join a carers service
- Join a carers support group
- Ask your local authority for a carers assessment
- Read about the condition
- Apply for welfare benefits for carers
Rethink Mental Illness run carers support groups in some areas. You can also search for groups on the Carers Trust website:
Rethink Mental Illness: www.rethink.org/about-us/our-support-groups Carers Trust www.carers.org/search/network-partners
How can I support the person I care for?
You might find it easier to support someone with schizoaffective disorder if you understand their symptoms, treatment and self-management skills.
You should be aware of what you can do if you are worried about their mental state or risk of self-harm. It can be helpful to know contact information for their mental health team or GP.
You could find out from your relative if they have a crisis plan. You could help your relative to make a crisis plan if they dont have one.
You can find out more information about:
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Psychotic Depression And Trauma
Since depression is a common feature of PTSD, psychotic depression in a patient with a history of trauma can be very difficult to differentiate from PTSD with psychotic features . Whether or not symptoms of comorbid PTSD are present, it is not known whether psychotic symptoms that directly reflect traumatic experiences in a depressed patient have different therapeutic or prognostic implications than mood congruent psychotic symptoms. The speculation that some of the relative treatment resistance reported with psychotic depression may be due to unrecognized PTSD has not been studied. It is not yet clear whether treatment of the combination of posttraumatic symptoms, depression, and psychosis should be similar to the treatment of psychotic depression in the absence of a significant trauma history.
How Infections Could Precipitate Mental Health Issues
The evidence for this theory that immune issues can contribute to mental health disorders is incomplete.
For one, Raison says that while it seems as though inflammation can contribute to depression, it has not appeared that blocking inflammation is a particularly robust way to either treat or prevent these disorders. So theres a big piece of the puzzle missing there. Another missing piece: There are some cases of depression where inflammation does not appear to play a big role, says McIntyre, and there are probably many unrecognized or underrecognized causes or contributors to mental health issues.
Finally, the mental health conditions mentioned in this piece depression, bipolar, schizophrenia are not fully understood to begin with. Scientists just generally dont understand how much biological overlap there is among them. With depression in particular, some scientists suspect it isnt just one disease, but perhaps many different ones that manifest with similar, overlapping symptoms.
So the big picture is complicated and incomplete.
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The Following Are Some Signs Of Worsening Schizophrenia:
- Disorganized speech: If the person with schizophrenia is speaking in a jumbled or incoherent manner, this could indicate that their medication needs to be adjusted or that they are experiencing a relapse of their illness.
- Reduced or increased social contact: If the person with schizophrenia becomes less social or more isolated this may be a sign that they are slipping back into old patterns of behavior. On the other hand, if they become too attached to a specific individual it could mean that they are developing a new delusion and need to speak to their doctor about adjusting their medication.
- Changes in appetite or weight: If the person with schizophrenia starts overeating and putting on weight, it could be a sign that they are experiencing negative symptoms related to their illness . On the other hand, if they start losing interest in food and begin losing weight, they may be experiencing hallucinations related to food.
- Changes in sleeping patterns: If the person stops sleeping for long periods of time every day, it could be due to their schizophrenia medication interfering with the quality of their sleep. An increase in nightmares or difficulty falling asleep are also common signs of schizophrenia worsening.
What Causes Psychotic Depression
The cause of psychotic depression is not fully understood. It’s known that there’s no single cause of depression and it has many different triggers.
For some, stressful life events such as bereavement, divorce, serious illness or financial worries can be the cause.
Genes probably play a part, as severe depression can run in families, although it’s not known why some people also develop psychosis.
Many people with psychotic depression will have experienced adversity in childhood, such as a traumatic event.
Treatment for psychotic depression involves:
- medicine a combination of antipsychotics and antidepressants can help relieve the symptoms of psychosis
- psychological therapies the 1-to-1 talking therapy cognitive behavioural therapy has proved effective in helping some people with psychosis
- social support support with social needs, such as education, employment or accommodation
The person may need to stay in hospital for a short period of time while they’re receiving treatment.
Electroconvulsive therapy may sometimes be recommended if the person has severe depression and other treatments, including antidepressants, have not worked.
Treatment is usually effective, but follow-up appointments so that the person can be closely monitored are usually required.
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How Is Psychosis Related To Schizophrenia
An individual with schizophrenia can experience periods of psychosis. During this time, they may have hallucinations and delusions. The psychotic symptoms of schizophrenia are also called positive symptoms.
Antipsychotic medications are used to treat acute psychotic episodes in people with schizophrenia. Additionally, these medications can also be used as maintenance medications to help prevent symptoms from coming back.
A diagnosis of schizophrenia can sometimes follow a psychotic episode. However, schizophrenia has some additional symptoms as well as specific diagnostic criteria.
A person can experience psychosis without having schizophrenia or another mental health disorder. Psychosis can occur due to things like substance use, medical conditions, and certain medications.
Bringing The Picture Together
The emerging picture of the genetic architecture of schizophrenia is revealing that hundreds of genes with small effect sizes influence the disorder . The genetic picture of depression is far less clear, with heritability estimates predicting a much greater contribution of environmental effects than in schizophrenia . Hence, it is not surprising that the array of factors that influence depression and schizophrenia-related phenotypes in rodent models is diverse. However, a number of common elements between these models are becoming evident. The emerging pathways that are shared between these models are represented in Figure 1.
Figure 1. Multiple shared pathways between rodent models which display both schizophrenia and depression-related phenotypes. This diagram illustrates the connections between each of the models and the biological processes which potentially underlie the observed phenotypes . Abbreviations: CSMD1, CUB and SUSHI multiple domains 1 DISC1, disrupted in schizophrenia 1 FEZ1, fasciculation and elongation protein zeta 1 GluD1, glutamate receptor delta 1 GSK-3, glycogen synthase kinase 3 MIA, maternal immune activation NPY, neuropeptide Y PDE4B, phosphodiesterase 4B PDLIM5, PDZ and LIM domain 5 SRR, serine racemase SI, social isolation.
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