Psychotic bipolar disorders: dimensionally similar to or categorically different from schizophrenia?

Ketter, Terence A.; Wang, Po; Becker, Olga; Nowakowska, Cecylia; Yang, Yen shou

doi:10.1016/s0022-3956(03)00099-2

Cited by 73 publications

(57 citation statements)

References 176 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with the view that a combination of dimensional and categorical models can be useful to reconcile the reality of variable clinical presentation of BD with defined diagnostic categories. 54,261,262 An important task for future phenotypic studies of BD will be to integrate findings from molecular, structural, cognitive, and clinical domains. For instance, we do not know if the heterogeneity of clinical and molecular-genetic findings is paralleled by similar differences at the cognitive or functional level.…”

Section: Resultsmentioning

confidence: 99%

“…An increasing number of authors are leaning towards the possibility of shared genetic basis. 52,53 Ketter et al 54 have examined whether the presence of psychotic symptoms defines a subgroup of BD or whether these symptoms constitute one of psychopathological dimensions of the illness. The authors propose that a combination of dimensional and categorical views is most compatible with the existing data.…”

Section: Psychotic Symptoms In Bdmentioning

confidence: 99%

See 1 more Smart Citation

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

View full text Add to dashboard Cite

The search for susceptibility genes for bipolar disorder (BD) depends on appropriate definitions of the phenotype. In this paper, we review data on diagnosis and clinical features of BD that could be used in genetic studies to better characterize patients or to define homogeneous subgroups. Clinical symptoms, long-term course, comorbid conditions, and response to prophylactic treatment may define groups associated with more or less specific loci. One such group is characterized by symptoms of psychosis and linkage to 13q and 22q. A second group includes mainly bipolar II patients with comorbid panic disorder, rapid mood switching, and evidence of chromosome 18 linkage. A third group comprises typical BD with an episodic course and favourable response to lithium prophylaxis. Reproducibility of cognitive deficits across studies raises the possibility of using cognitive profiles as endophenotypes of BD, with deficits in verbal explicit memory and executive function commonly reported. Brain imaging provides a more ambiguous data set consistent with heterogeneity of the illness. Keywords: bipolar disorder; genetics; endophenotype; neurocognitive function; brain imaging Bipolar disorder (BD) has a genetic basis with heritability of at least 80%. 1 A number of studies have attempted to map the susceptibility loci giving evidence of linkage in multiple genomic regions. In particular, findings in 4p, 4q, 8q, 10p, 12q24, 13q, 18p, 18q, 21q, and 22q have been supported by more than one study. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] However, these studies have not identified any specific genes, and a recent metaanalysis of available genome scans showed no regions with a conclusive evidence of linkage. 20 The relatively slow progress of gene-mapping efforts is often explained by the 'complex' nature of the illness and of the genotype-phenotype relation. The complexity most likely includes heterogeneity, interactions of multiple loci, incomplete penetrance, as well as phenotypes resulting from environmental effects-either alone or in interaction with the genetic predisposition. The goal of psychiatric genetic research is identification of (heritable) variations in DNA sequence or function that influence behaviour or give rise to mental illness. By definition, in complex (multifactorial) traits, this link is not unique and specific. That is, a particular change in gene sequence does not necessarily lead to a specific behaviour, and similar behaviours (symptoms) may be due to distinct (sets of) genes. Moreover, we must consider the possibility that the path between the genotype and behaviour is not unidirectional. Emerging examples point not only to general effects of environment, for instance stress, on behaviour, but also to specific behaviours influencing gene function that can be transmitted onto the next generation. 21 No single method is considered clearly superior in identifying susceptibility genes for complex traits such as BD. Most researchers agree that a combination of strategies is most lik...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Psychotic Symptoms In Bdmentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

View full text Add to dashboard Cite

show abstract

“…A ' transdiagnostic ' approach to first-episode psychosis, with its inherent limitations in validity and reliability, affects the generalizability of outcome studies as the natural history of different disorders varies (Ketter et al 2003). For this reason phenomenological approaches to early schizophrenia that encompass altered subjective experiences, rather than relying entirely on syndromal diagnosis (as inherent in DSM-IV-TR and ICD-10), are emerging as attractive areas for further study (Parnas, 2005).…”

Section: ' Caseness ' In Early Psychosismentioning

confidence: 99%

Early intervention in psychotic disorders: faith before facts?

2009

View full text Add to dashboard Cite

show abstract

“…A principal component analysis of the 30 PANSS item scores of the 535 patients with a diagnosis of a manic episode at baseline was conducted. Results: Five factors were extracted by the analysis: anxiety (13.4% of the variance), negative symptoms Several authors have questioned whether schizophrenia and bipolar disorder represent separate categories of diseases or are separate dimensions of a single disease [5][6][7] . In 1986, Crow [8] proposed that 'psychosis is a continuum extending from unipolar through bipolar affective illness and schizoaffective psychosis to typical schizophrenia, with increasing degrees of defect'.…”

Section: Introductionmentioning

confidence: 99%

Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

et al. 2008

View full text Add to dashboard Cite

Background: Psychosis is present in 50% or more of patients with bipolar mania and is commonly evaluated in clinical research by means of the Positive and Negative Syndrome Scale (PANSS). The aim of the present analysis was to investigate the psychotic dimensions of bipolar disorder and its contributing symptoms based on a factor analysis of baseline PANSS scores and to compare them with those identified in studies of patients with schizophrenia and bipolar disorder. Sampling and Methods: Baseline data were analyzed from two 3-week, double-blind, placebo-controlled studies of risperidone monotherapy for acute mania associated with bipolar I disorder (n = 535). Inclusion criteria were a DSM-IV diagnosis of bipolar I disorder with manic features, with or without psychotic features, age ≧18 years, and mean baseline Young Mania Rating Scale scores ≧20. A principal component analysis of the 30 PANSS item scores of the 535 patients with a diagnosis of a manic episode at baseline was conducted. Results: Five factors were extracted by the analysis: anxiety (13.4% of the variance), negative symptoms (12.3%), depression (10.5%), excitement (10.3%), and positive symptoms (8.7%). Similar factors, in particular the negative, excitement, and positive factors, have been identified in patients with schizophrenia. There was an absence of a cognitive factor supporting the notion that bipolar patients may present fewer cognitive symptoms. Conclusion: The results of the present analysis and those of other studies indicate similarities in psychotic symptom domains, as measured by the PANSS, in patients with bipolar mania and schizophrenia. Future analyses will address the effects of treatment on the identified factors.

show abstract

Psychotic bipolar disorders: dimensionally similar to or categorically different from schizophrenia?

Cited by 73 publications

References 176 publications

The phenotypes of bipolar disorder: relevance for genetic investigations

The phenotypes of bipolar disorder: relevance for genetic investigations

Early intervention in psychotic disorders: faith before facts?

Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

Contact Info

Product

Resources

About