Aykut Demet Sağlam, Arslan Filiz Civil, Özkorumak Evrim, Tiryaki Ahmet
Karadeniz Technical University, Faculty of Medicine, Department of Psychiatry, Kalkınma Mah., 61080 Trabzon, Turkey,
Psychiatr Danub. 2017 Jun;29(2):141-147. doi: 10.24869/psyd.2017.141.
Schizophrenia (SCH) and bipolar affective disorder (BAD) are currently classified separately according to the DSM (The Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Statistical Classification of Diseases and Related Health Problems) standardized diagnostic guidelines. However, the validity of this categorical approach is controversial because psychotic symptoms may be observed in both diagnoses. The purpose of this study was to compare the clinical and social characteristics in a sample group consisting of patients diagnosed with SCH or BAD to help demonstrate the basic difficulty in the current classification of SCH and BAD as two etiologically distinct diseases.
The study sample group consisted of 102 patients diagnosed with SCH and 92 patients diagnosed with BAD. All of the participants were evaluated by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition with regard to beginning symptoms of the disease, the symptoms and signs of active disease period within total disease duration, continuining residual symptoms in intermediate period. The patients were administered the Positive and Negative Syndrome Scale, the Quality of Life Enjoyment and Satisfaction Questionnaire and the Social Functioning Scale.
The SCH and BAD groups in this study were statistically similar in terms of sex, length of education, age at disease onset, attempted suicide, quality of life and social functioning.
Our study findings indicated that the course of disease in patients with BAD-1, in which psychotic features predominate and which exhibits a recurring course, shares various characteristics with SCH. It can be concluded that further phenomenological and neurobiological evaluations are required for intermediate cases with similiar clinical characteristics with schizophrenia and bipolar disorders.
精神分裂症（SCH）和双相情感障碍（BAD）目前根据《精神疾病诊断与统计手册》（DSM）和《国际疾病及相关健康问题统计分类》（ICD）的标准化诊断指南进行分别分类。然而，这种分类方法的有效性存在争议，因为两种诊断中都可能观察到精神病性症状。本研究的目的是比较由诊断为SCH或BAD的患者组成的样本组的临床和社会特征，以帮助证明目前将SCH和BAD分类为两种病因不同疾病的基本困难。
研究样本组由102例诊断为SCH的患者和92例诊断为BAD的患者组成。所有参与者均通过《精神疾病诊断与统计手册》第四版的结构化临床访谈，对疾病的起始症状、疾病总病程中活动期的症状和体征、中期持续的残留症状进行评估。对患者进行阳性和阴性症状量表、生活质量享受与满意度问卷以及社会功能量表测评。
本研究中的SCH组和BAD组在性别、受教育年限、发病年龄、自杀未遂、生活质量和社会功能方面在统计学上相似。
我们的研究结果表明，BAD-1型患者（以精神病性特征为主且呈复发病程）的疾病过程与SCH有多种共同特征。可以得出结论，对于具有与精神分裂症和双相情感障碍相似临床特征的中间病例，需要进一步进行现象学和神经生物学评估。
