Sicignano J R, Lichtenstein J
Hosp Community Psychiatry. 1978 Feb;29(2):112-4. doi: 10.1176/ps.29.2.112.
Ten patients in a Veterans Administration hospital who had been diagnosed and treated as schizophrenic were rediagnosed as having bipolar affective illness and were shown to be responsive to lithium. The authors feel that the diagnosis of schizophrenia is made too frequently and often is made with inadequate information. A further complicating factor in diagnosis is that some patients exhibit schizophrenia-like symptoms during the acute manic phase. The authors found that valuable aids to rediagnosis of such patients include a good premorbid and interepisodic adjustment, a history of depressive episodes, a family history of affective disorder, and a favorable response to a therapeutic trial on lithium carbonate.
一家退伍军人管理局医院的10名曾被诊断为精神分裂症并接受治疗的患者，被重新诊断为双相情感障碍，且被证明对锂盐治疗有反应。作者认为精神分裂症的诊断过于频繁，而且往往是在信息不足的情况下做出的。诊断中的另一个复杂因素是，一些患者在急性躁狂期会出现类似精神分裂症的症状。作者发现，对这类患者进行重新诊断的有价值的辅助手段包括病前和发作间期的良好适应、抑郁发作史、情感障碍家族史以及对碳酸锂治疗试验的良好反应。
