Phenomenology of first-episode psychosis in schizophrenia, bipolardisorder, and unipolar depression: A comparative analysis

Cherise Rosen, Robert Marvin, James L. Reilly, Ovidio DeLeon, Margret S H Harris, Sarah K. Keedy, Hugo Solari, Peter Weiden, John A. Sweeney

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: This study sought to identify similarities and differences in symptom characteristics at initial presentation of first psychotic episodes in schizophrenia, bipolar disorder and unipolar depression. Methods: The Structured Interview for DSM-IV (SCID) and Positive and Negative Syndrome Scale (PANSS) were administered to consecutive admission study-eligible patients (n=101) presenting for treatment during their first acute phase of psychotic illness. Forty-nine percent of patients met diagnostic criteria for schizophrenia, 29% for psychotic bipolar disorder and 22% for unipolar depression with psychosis. The PANSS was analyzed using five-factor scoring that included Positive, Negative, Cognitive, Excitement, and Depression factors, and composite cluster scores that assessed Anergia, Thought Disturbance, and Paranoia. Results: Schizophrenia and bipolar disorder patients demonstrated significantly more Positive symptoms, Thought Disturbance and Paranoia than unipolar depressed patients. Schizophrenia and unipolar depressed patients demonstrated significantly more Negative symptoms and Anergia than bipolar patients. Patients with schizophrenia reported more severe Cognitive Disorganization than patients with either bipolar disorder or unipolar depression (p<.05). Conclusions: Findings from this study demonstrate an informative pattern of similarities and differences in the phenomenology of psychotic disorders at first illness presentation. Commonalities in symptom profiles reflect considerable symptom overlap among psychotic disorders and, thus, the importance of multidimensional differential diagnosis for these conditions. The differences across disorders in Positive and Negative symptom severity, Thought Disorder, Paranoia, and Anergia, and especially the higher level of Cognitive Disorganization seen in schizophrenia patients, point to clinically informative differences across these disorders that are relevant to clinical diagnostic practice and models of psychopathology.

Original languageEnglish (US)
JournalClinical Schizophrenia and Related Psychoses
Volume6
Issue number3
DOIs
StatePublished - Oct 2012

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Depressive Disorder
Psychotic Disorders
Schizophrenia
Bipolar Disorder
Paranoid Disorders
Psychopathology
Diagnostic and Statistical Manual of Mental Disorders
Differential Diagnosis
Interviews
Depression

Keywords

  • First episode
  • Phenomenology
  • Psychosis

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Phenomenology of first-episode psychosis in schizophrenia, bipolardisorder, and unipolar depression : A comparative analysis. / Rosen, Cherise; Marvin, Robert; Reilly, James L.; DeLeon, Ovidio; Harris, Margret S H; Keedy, Sarah K.; Solari, Hugo; Weiden, Peter; Sweeney, John A.

In: Clinical Schizophrenia and Related Psychoses, Vol. 6, No. 3, 10.2012.

Research output: Contribution to journalArticle

Rosen, Cherise ; Marvin, Robert ; Reilly, James L. ; DeLeon, Ovidio ; Harris, Margret S H ; Keedy, Sarah K. ; Solari, Hugo ; Weiden, Peter ; Sweeney, John A. / Phenomenology of first-episode psychosis in schizophrenia, bipolardisorder, and unipolar depression : A comparative analysis. In: Clinical Schizophrenia and Related Psychoses. 2012 ; Vol. 6, No. 3.
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