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What’s Worse Schizophrenia Or Bipolar

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Quality Of Life Of People With Schizophrenia Bipolar Disorder And Other Psychotic Disorders

What is Schizoaffective Disorder- Is It Worse Than Bipolar Disorder?

Published online by Cambridge University Press: 02 January 2018

Samuli I. Saarni*
Affiliation:Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, and the Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki
Satu Viertiö
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki
Jonna Perälä
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki
Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki
Jouko Lönnqvist
Affiliation:Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, and the Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki
Jaana Suvisaari
Affiliation:Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
*
Samuli I. Saarni, MD, PhD, MSocSc, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, 00270 Helsinki, Finland. Email:

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.

How Is Schizoaffective Disorder Diagnosed

A psychiatrist will diagnose schizoaffective disorder after a mental health assessment. It might take more than one assessment for the psychiatrist to reach a diagnosis. You may get a diagnosis of schizoaffective disorder if you have depressive or manic symptoms with symptoms of schizophrenia.

Psychiatrists will use the following manuals to help to diagnose you:

  • International Classification of Diseases produced by the World Health Organisation
  • Diagnostic and Statistical Manual produced by the American Psychiatric Association.

The manuals are guides which explain different mental health conditions and their symptoms. They also explain how long certain symptoms should last for before a diagnosis should be made.

To get a diagnosis of schizoaffective disorder you should have had a combination of symptoms of both psychosis and bi-polar disorder. Your symptoms should be clearly there for at least 2 weeks.

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What Are The Symptoms Of Schizoaffective Disorder

Symptoms of schizoaffective disorder are:

What are the symptoms of schizophrenia?

Schizophrenia is a mental illness which affects the way you think. Symptoms can effect how you cope with day to day life. Symptoms include.

  • Hallucinations. You may hear, see, or feel things that arent there.
  • Delusions. You may believe things that arent true.
  • Disorganised speech. You may begin to talk quickly or slowly, and the things you say might not make sense to other people. You may switch topics without any obvious link.
  • Disorganised behaviour. You might struggle to organise your life, or stick to appointments, for example.
  • Catatonic behaviour. You may feel unable to move or appear to be in daze.
  • Negative symptoms. These are symptoms that involve loss of ability and enjoyment in life. They can include the following things.
  • Lack of motivation

You can find more information about Schizophrenia by clicking here.

What are the symptoms of mania?

You may experience the following if you have mania.

Mania is associated with bipolar disorder.

You can find more information about Bipolar disorder by clicking here.

What are the symptoms of depression?

You may feel the following if you have depressive symptoms.

  • Sleep too much, not being able to sleep or have disturbed sleep,
  • More or less hungry than usual or have a weight change, or
  • Thoughts of death or suicide or attempt suicide.

You can find more information about Depression by clicking here.

Duration Of Symptoms And Disease

What to know about bipolar disorder

The psychotic symptoms of schizophrenia tend to be persistent, while in schizoaffective disorder, they tend to come and go.

In terms of the course of the disease, most people who are diagnosed with schizophrenia have a chronic and persistent course of illness.

On the other hand, most people diagnosed with schizoaffective disorder experience episodes of symptoms but are more likely to have symptom-free intervals than people who have schizophrenia. This is not a hard and fast rule, however in some people, the opposite is true.

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Differences In Persons Functionality

If you live with bipolar disorder, you may be able to function in the world with and sometimes without treatment. It depends on the severity and type of symptoms.

The outlook for people with schizophrenia may be different.

Some people with schizophrenia see an improvement in their symptoms to the point where they can function independently.

For others, symptoms can improve with daily living supports, such as medications and therapy.

For some, symptoms might not improve.

What Is Schizoaffective Disorder

Schizoaffective disorder is a condition on the schizophrenia spectrum, but it is not the same condition as schizophrenia. You may think of schizoaffective disorder as a combination of schizophrenia-like symptoms such as paranoia, hallucinations, and social isolation, as well as mood symptoms that may resemble either bipolar disorder or depression.

Schizoaffective disorder symptoms can look different from person to person. People who have bipolar disorder often have psychotic symptoms, so there can be a lot of overlap between the two conditions. Therefore, one person with schizoaffective disorder may have a more severe mental illness than a different person with bipolar disorder. This is not a hard-and-fast rule, as bipolar disorder, especially when it includes psychotic symptoms, can be quite severe.

Schizoaffective disorder is a diagnosis that combines psychotic symptoms and mood symptoms into one label. Its important that your doctor rules out other conditions such as bipolar disorder, depression, drug use, and schizophrenia before diagnosing you with this condition.

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Bipolar With Psychotic Features

Psychosis describes a disconnect from reality, a state of mind where you have trouble recognizing whats real and what isnt. In terms of bipolar disorder, psychosis mainly refers to hallucinations or delusions.

Other key symptoms of psychosis, such as changes in sleep patterns or problems with concentration, can seem very similar to those that characterize mood episodes.

These symptoms can be mood congruent, meaning theyre consistent with your other symptoms. They can also be mood incongruent, or inconsistent with your other symptoms. Believing you have superpowers during an episode of depression, for example, would be considered mood-incongruent psychosis.

Psychosis can happen during both manic and depressive episodes. An episode of hypomania that involves psychosis automatically meets the criteria for mania.

Could My Bipolar Brother Develop Schizophrenia

What is the difference between schizophrenia, schizoaffective disorder, and bipolar disorder?

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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How Do Schizoaffective Disorder And Bipolar Disorder Differ

Physicians have a difficult time diagnosing schizoaffective disorder, and its a common mistake to believe someone is struggling with bipolar as opposed to the other condition. Bipolar disorder consists of similar symptoms, which include episodes of depression and mania. Someone with schizoaffective disorder will experience psychosis, such as delusions and hallucinations. Due to the overlap in symptoms, achieving the proper diagnosis requires a thorough examination.

An individual can have both schizoaffective and bipolar disorder, which can further complicate the diagnosis. The overlapping symptoms include:

  • Psychotic episodes: In some cases of bipolar disorder, hallucinations and delusions can arise during severe episodes of depression or mania
  • Disorganized thinking: This is common in schizoaffective disorder, but someone struggling with bipolar will have disorganized thoughts during an episode of mania.
  • Symptoms of depression: During extended periods of depression, someone with either condition may demonstrate a loss of interest in activities they once enjoyed. For some, they cannot experience pleasure, will have trouble concentrating, and cannot make decisions.

There are reports that highlight high rates of alcohol and drug misuse among those with either condition. When someone has a significant symptom overlap, they will receive a diagnosis of schizoaffective disorder.

What Are Causes And Risk Factors For Bipolar Disorder And Schizophrenia

Like most mental disorders, neither bipolar disorder nor schizophrenia is directly passed down genetically. Rather, each is the result of a complex group of genetic, psychological, and environmental factors. These two illnesses share a number of the same risk genes but also have some unique genetic risk factors. Stress is a significant contributor to the development of most mental health conditions, including both of these disorders.

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Bipolar Disorder Vs Schizophrenia

Can A Bipolar Person Tell If They Are Bipolar

What Is Bipolar 2 Disorder

So no, not everyone who has bipolar disorder knows they have it. There are lots of reasons why someone with bipolar disorder might not realize itor why they might deny having it even if they do. If you think someone you know might have untreated bipolar disorder, there are a few things you can do to help.

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How Can Bipolar Disorder And Schizophrenia Be Prevented

Bipolar disorder and schizophrenia are both common diseases. Having either one of these conditions can increase the risk of other serious mental illnesses.

However, both bipolar disorder and schizophrenia are treatable. Treatment can help people manage their symptoms and improve their quality of life.

Bipolar disorder is treated with medication and psychotherapy. Treatment for schizophrenia can include antipsychotics and mood stabilizers.

What Causes Bipolar Disorder

Doctors don’t know for sure, but they think a mix of things can make you more likely to get it.

Brain structure and chemistry. People with the illness may have changes in the brain itself, as well as in the way chemicals called neurotransmitters work. These chemicals send information between nerve cells.

Genes. You’re more likely to have it if someone in your family does, so your genes probably have something to do with it.

Stress. Emotional events, like the death of a loved one, can trigger bipolar disorder for the first time, so how you handle stress may play a role, too.

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What Is The Outlook For People With Bipolar Disorder And Schizophrenia

Bipolar disorder and schizophrenia are both chronic diseases. However, they can be successfully treated. The outlook for people with these diseases depends on the severity of the symptoms and how well treatment is provided.

For bipolar disorder, its common to experience severe symptoms for several weeks or months. However, the symptoms usually go away when the persons medication is stopped.

For schizophrenia, symptoms may last for a few weeks to a few years. However, with treatment, symptoms usually go away.

Dimensions Of Hrqol Influenced By Different Disorders

Living with Schizoaffective Disorder

The HRQoL profiles are presented in Fig. 1, in the form of age- and gender-adjusted decreases from population averages. The decreases were widespread for schizophrenia and schizoaffective disorder but less so for bipolar I disorder .

Fig. 1 Age- and gender-adjusted losses on different health-related quality of life dimensions with 95% CI. Schizophrenia, schizoaffective disorder, bipolar I disorder.

The 15 dimensions: Move, mobility See, vision Hear, hearing Breath, breathing Sleep, sleeping Eat, eating Speech, speaking Elim, elimination Uact, usual activity Mental, mental function Disco, discomfort and symptoms Depr, depression Distr, distress Vital, vitality Sex, sexuality.

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Studies Comparing Different Psychotic Disorders On Any Qol/hrqol Measures

A review of the literature up to the year 2002 using a very wide conceptualisation of HRQoL ) found 65 studies.Reference Dean, Gerner and Gerner42 Eight of the nine studies comparing bipolar disorder with schizophrenia suggested better HRQoL for people with bipolar disorder. Another review up to 2004 included 28 articles with five studies comparing bipolar disorder with other conditions.Reference Michalak, Yatham and Lam43 Most of these showed bipolar disorder to be comparable or milder than schizophrenia. Two studies suggested that the HRQoL of participants with bipolar disorder was equivalent to that of the general population.

Our results fit with the previous literature in suggesting that, on average, schizoaffective disorder is associated with more severe HRQoL impairment than schizophrenia. Bipolar I disorder has been associated with a smaller or similar HRQoL impact to schizophrenia, depending on the sample and the measures used.

Can Bipolar Disorder & Schizophrenia Overlap

Despite the differences between these two conditions, symptoms can overlap. If you are suffering from either of these mental health disorders, you might experience the following.

  • Psychotic Episodes: Sufferers of bipolar disorder or schizophrenia may experience delusions during an episode. However, someone with a schizophrenic disorder is more likely to experience auditory illusions, whereas people with bipolar disorder tend to hallucinate visually.
  • Depressive Tendencies: Patients lose interest in hobbies, experience difficulty sleeping, or become unable to sustain a job.
  • Irrational & Disorganized Thinking: While schizophrenic people are more likely to experience disorganized thinking, people with a mood disorder may also have difficulty concentrating and making decisions.

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Symptoms Of Bipolar Disorder

People living with bipolar disorder tend to undergo intense mood shifts that occur rapidly or over an extended time. They can experience three types of episodes:

  • Manic: Those having a manic episode may feel extremely elated, wired, jumpy, or irritable. They are highly energetic and active their mood is expansive.
  • Hypomanic: People undergoing hypomania will have less intense manic symptoms.
  • Depressive: Those having a depressive episode may feel and lose interest in activities they used to enjoy. This mimics the symptoms of major depression.

People may be diagnosed with bipolar I disorder after having at least one episode of mania. They can be diagnosed with bipolar II disorder after undergoing a major depressive episode and hypomania.

These mood shifts may not occur continuously. Even if you experience periods of stable mood occasionally, you can be diagnosed with bipolar disorder as long as you fit the diagnostic criteria.

Cyclothymia, a less-intense condition, is diagnosed after someone exhibits alternating episodes of low-level depression and hypomania.

Other behavioral changes that may be symptoms of bipolar disorder include:

can run in families .

This doesnt mean someone will inherit the disorders if their parent or sibling has them. The risk increases, however, if multiple family members do. But just being aware of that risk increases the chance of early detection and treatment.

Mania With Psychosis Vs Schizophrenia Vs Schizoaffective Disorder Bipolar Type

What is Schizoaffective Disorder?

David N. Osser, MDPsychiatric Times

Have you had difficulty with differential diagnosis when patients have manic symptoms and psychosis? One doctor discusses the related DSM-5 criteria changes and some of their implications for psychopharmacology.

BIPOLAR UPDATE

Have you had difficulty with differential diagnosis when the patient has manic symptoms and psychosis? In 2013, the DSM-5 made the issue clearer with significant changes in the criteria defining the quantity and nature of mood symptoms in these diagnoses. As a result, more patients will be diagnosed with schizophrenia compared with when using DSM-IV in either the TM or later Text Revised TR version. I will propose some of the implications for psychopharmacology.

In the schizophrenia D criteria in DSM-5, the patient should have no mood episodes during the active phase of the illness, or, if the patient has episodes, those episodes occur during a minority of the total duration of the illness . In other words, a patient with schizophrenia can have a full manic syndrome present for up to 50% of the time, as long as the other schizophrenia criteria are met. Those criteria include, from the A criteria, positive symptoms during the acute phase the B criteria of illness duration of at least 6 months of the active and residual phases the C criteria of deterioration in functioning compared to premorbid levels and the E criteria of no explanation of it from a substance or medical illness.

References

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