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Cross-sectional similarities and differences between schizophrenia, schizoaffective disorder and mania or mixed mania with mood-incongruent psychotic features

Published online by Cambridge University Press:  16 April 2020

Stefano Pini ,
Valeria de Queiroz ,
Liliana Dell'Osso ,
Marianna Abelli ,
Concettina Mastrocinque ,
Marco Saettoni ,
Mario Catena  and
Giovanni B. Cassano
Stefano Pini*
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Valeria de Queiroz
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Liliana Dell'Osso
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Marianna Abelli
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Concettina Mastrocinque
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Marco Saettoni
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Mario Catena
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
Giovanni B. Cassano
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, 56100Pisa, Italy
*
*Corresponding author. E-mail address:s.pini@psico.med.unipi.it (S. Pini).
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Abstract

Background. – The cross-sectional clinical differentiation of schizophrenia or schizoaffective disorder from mood-incongruent psychotic mania or mixed mania is difficult, since pathognomonic symptoms are lacking in these conditions.

Aims of the study. – To compare a series of clinical variables related to mood and cognition in patient groups with DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, mood-incongruent psychotic mania and mood-incongruent psychotic mixed mania.

Methods. – One hundred and fifty-one consecutive patients were evaluated in the week prior to discharge by using the structured clinical interview for DSM-III-R-patient edition (SCID-P). Severity of psychopathology was assessed by the 18-item version of the brief psychiatric rating scale (BPRS) and negative symptoms by the scale for assessment of negative symptoms (SANS). Level of insight was assessed with the scale to assess unawareness of mental disorders (SUMD).

Results. – There were no differences in rates of specific types of delusions and hallucinations between subjects with schizophrenia, schizoaffective disorder, psychotic mania and psychotic mixed mania. SANS factors scores were significantly higher in patients with schizophrenia than in the bipolar groups. Patients with mixed state scored significantly higher on depression and excitement compared to schizophrenia group and, to a lesser extent, to schizoaffective group. Subjects with schizophrenia showed highest scores on the SUMD indicating that they were much more compromised on the insight dimension than subjects with psychotic mania or mixed mania.

Conclusion. – Negative rather than affective symptomatology may be a useful construct to differentiate between schizophrenia or schizoaffective disorders from mood-incongruent psychotic mania or mixed mania.

Keywords

Mood-incongruent psychotic featuresManiaBipolar disorderSchizophreniaAwareness of illness
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 1 , January 2004 , pp. 8 - 14
Copyright
Copyright © 2003 European Psychiatric Association

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