A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia: The Schizo-Bipolar Scale

Matcheri S. Keshavan, David W. Morris, John A. Sweeney, Godfrey Pearlson, Gunvant Thaker, Larry J. Seidman, Shaun M. Eack, Carol Tamminga

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Background: There is increasing evidence for phenomenological, biological and genetic overlap between schizophrenia and bipolar disorder, bringing into question the traditional dichotomy between them. Neurobiological models linked to dimensional clinical data may provide a better foundation to represent diagnostic variation in neuropsychiatric disorders. Method: To capture the interaction between psychosis and affective symptoms dimensionally, we devised a brief descriptive scale based on the type and relative proportions of psychotic and affective symptoms over the illness course. The scale was administered to a series of 762 patients with psychotic disorders, including schizophrenia, schizoaffective and psychotic bipolar disorder assessed as part of the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) study. Results: The resulting Schizo-Bipolar Scale scores across these disorders showed neither a clear dichotomy nor a simple continuous distribution. While the majority of cases had ratings close to prototypic schizophrenia or bipolar disorder, a large group (45% of cases) fell on the continuum between these two prototypes. Conclusions: Our data suggest a hybrid conceptualization model with a representation of cases with prototypic schizophrenia or bipolar disorder at the extremes, but a large group of patients on the continuum between them that traditionally would be considered schizoaffective. A dimensional approach, using the Schizo-Bipolar Scale, characterized patients across a spectrum of psychopathology. This scale may provide a valuable means to examine the relationships between schizophrenia and psychotic bipolar disorder.

Original languageEnglish (US)
Pages (from-to)250-254
Number of pages5
JournalSchizophrenia Research
Volume133
Issue number1-3
DOIs
StatePublished - Dec 2011

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Bipolar Disorder
Psychotic Disorders
Schizophrenia
Affective Symptoms
Psychopathology
Phenotype

Keywords

  • Bipolar disorder
  • Continuum
  • Schizoaffective disorder
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia : The Schizo-Bipolar Scale. / Keshavan, Matcheri S.; Morris, David W.; Sweeney, John A.; Pearlson, Godfrey; Thaker, Gunvant; Seidman, Larry J.; Eack, Shaun M.; Tamminga, Carol.

In: Schizophrenia Research, Vol. 133, No. 1-3, 12.2011, p. 250-254.

Research output: Contribution to journalArticle

Keshavan, Matcheri S. ; Morris, David W. ; Sweeney, John A. ; Pearlson, Godfrey ; Thaker, Gunvant ; Seidman, Larry J. ; Eack, Shaun M. ; Tamminga, Carol. / A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia : The Schizo-Bipolar Scale. In: Schizophrenia Research. 2011 ; Vol. 133, No. 1-3. pp. 250-254.
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