Diagnostic stability of schizophrenia: A systematic review

Palomar-Ciria, Nora; Cegla-Schvartzman, Fanny; López-Moriñigo, Javier-David; Bello, Hugo J.; Ovejero, Santiago; Baca‐García, Enrique

doi:10.1016/j.psychres.2019.04.020

Cited by 16 publications

(12 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present findings are important, given that male sex and family history of mental illness are factors associated with diagnostic stability in SCH over time. 30 These findings are also relevant within the clinical context, in which the specialized interventions must be differentiated by sex. One study reported that males with SCH and comorbid substance abuse were hospitalized more often, and more often subjected to mechanical restraint.…”

Section: Discussionmentioning

confidence: 95%

Family History of Psychiatric Disorders and Clinical Factors Associated With a Schizophrenia Diagnosis

Díaz-Castro

Hoffman

Cabello-Rangel³

et al. 2021

INQUIRY

View full text Add to dashboard Cite

Background Schizophrenia (SCH) and bipolar disorder (BD) have both shared and unique genetic risk factors and clinical characteristics. The aim of the present study was to identify potential risk factors significantly associated with SCH, relative to a BD reference group. Methods Data were obtained from medical records of patients that entered a major Mexico City hospital during 2009–2010 presenting psychotic symptoms (n = 1132; 830 cases of SCH, 302 cases of BD; 714 men and 418 women). SCH and BD diagnoses were compared with respect to a number of family and clinical characteristics. Logistic and linear regression analyses were used to respectively identify factors selectively associated with the SCH diagnosis relative to the BD diagnosis and explore the relationship between PANSS scores and parental age at time of birth to the age of SCH onset. Results Patients with SCH showed greater functional impairment than those with BD. Family history of mental illness, premorbid schizoid-like personality, and obstetric trauma were significantly associated with the SCH diagnosis. The association of obstetric trauma with SCH was greatest in male patients with a family history of mental illness. In women, increased paternal and decreased maternal age at time of the patient’s birth were associated with an earlier age of SCH onset. Conclusion Male gender, showing premorbid schizoid-like personality, familial SCH, and obstetric trauma are risk factors that distinguish SCH from BD. Additionally, our results suggest that risk for SCH relative to BD may be importantly influenced by interactions between familial risk, gender, and obstetric trauma.

show abstract

Section: Discussionmentioning

confidence: 95%

Family History of Psychiatric Disorders and Clinical Factors Associated With a Schizophrenia Diagnosis

Díaz-Castro

Hoffman

Cabello-Rangel³

et al. 2021

INQUIRY

View full text Add to dashboard Cite

show abstract

“…Errors in both directions are not infrequent. 1,[48][49][50] Maijer et al 51 have proposed a comprehensive strategy for managing hallucinations in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

Hearing Voices and Seeing Things: Symptoms of Anxiety Misconstrued as Evidence of Schizophrenia in an Adolescent

Camerini

Baker

Gadelha

et al. 2021

Journal of Psychiatric Practice

View full text Add to dashboard Cite

A patient’s complaint of “hearing voices” or “seeing things” or of similar perceptual abnormalities leaves the clinician with 2 decisions: (1) Is the patient actually experiencing a hallucination, or does the complaint reflect a different mental experience, ranging from outright fabrication to the misinterpretation or mislabeling of vivid thoughts and emotions? (2) How should the experience reported by the patient, whether determined to be a hallucination or not, be understood in the context of the patient’s entire history and mental state? We report the case of a 16-year-old whose cartoon-like hallucinations had led to the diagnosis of schizophrenia and had directed attention of the patient, her parents, and her clinicians away from critical issues of anxiety, depression, learning difficulties, and traumatic school experiences. This case illustrates how the diagnosis of schizophrenia can be driven by the prominence and vividness of psychotic-like symptoms reported by a patient, the expectation that patients’ chief complaints must be directly and immediately addressed, insufficient attention to collateral information, and the distortions of a “checklist” approach to psychiatric diagnosis driven by the criteria in the Diagnostic and Statistical Manual of Mental Disorders, insurers, and the properties of electronic medical records. Given the consequences of either underdiagnosing or overdiagnosing schizophrenia, and the current lack of validated objective tests to assist with this diagnosis, clinicians are obligated to perform a thorough clinical assessment of such patients, including a probing exploration of the patient’s mental state and a systematic collection of collateral information.

show abstract

“…It is expressed as the percentage of patients consistently diagnosed as meeting the criteria of a specific disorder over time. A recent systematic review demonstrated mean diagnostic stability for schizophrenia of 84.3% and 67.1% for prospective and retrospective studies, respectively [63]. The following factors were associated with greater diagnostic stability: male sex, older age at study inception, older age at onset, late stages of illness, family history of mental illness, poorer functioning and longer length of hospital stay.…”

Section: Validity Of Diagnosismentioning

confidence: 99%

The future of diagnosis in clinical neurosciences: Comparing multiple sclerosis and schizophrenia

Misiak,

Samochowiec,

Kowalski

et al. 2023

Eur. Psychiatr.

View full text Add to dashboard Cite

The ongoing developments of psychiatric classification systems have largely improved reliability of diagnosis, including that of schizophrenia. However, with an unknown pathophysiology and lacking biomarkers, its validity still remains low, requiring further advancements. Research has helped establish multiple sclerosis (MS) as the central nervous system (CNS) disorder with an established pathophysiology, defined biomarkers and therefore good validity and significantly improved treatment options. Before proposing next steps in research that aim to improve the diagnostic process of schizophrenia, it is imperative to recognize its clinical heterogeneity. Indeed, individuals with schizophrenia show high interindividual variability in terms of symptomatic manifestation, response to treatment, course of illness and functional outcomes. There is also a multiplicity of risk factors that contribute to the development of schizophrenia. Moreover, accumulating evidence indicates that several dimensions of psychopathology and risk factors cross current diagnostic categorizations. Schizophrenia shares a number of similarities with MS, which is a demyelinating disease of the CNS. These similarities appear in the context of age of onset, geographical distribution, involvement of immune-inflammatory processes, neurocognitive impairment and various trajectories of illness course. This article provides a critical appraisal of diagnostic process in schizophrenia, taking into consideration advancements that have been made in the diagnosis and management of MS. Based on the comparison between the two disorders, key directions for studies that aim to improve diagnostic process in schizophrenia are formulated. All of them converge on the necessity to deconstruct the psychosis spectrum and adopt dimensional approaches with deep phenotyping to refine current diagnostic boundaries.

show abstract

Diagnostic stability of schizophrenia: A systematic review

Cited by 16 publications

References 59 publications

Family History of Psychiatric Disorders and Clinical Factors Associated With a Schizophrenia Diagnosis

Family History of Psychiatric Disorders and Clinical Factors Associated With a Schizophrenia Diagnosis

Hearing Voices and Seeing Things: Symptoms of Anxiety Misconstrued as Evidence of Schizophrenia in an Adolescent

The future of diagnosis in clinical neurosciences: Comparing multiple sclerosis and schizophrenia

Contact Info

Product

Resources

About