Winokur G
Br J Psychiatry. 1984 Sep;145:236-42. doi: 10.1192/bjp.145.3.236.
Bipolar and unipolar patients respectively were separated into psychotic and non-psychotic sub-types. The bipolar psychotic patients were more likely to have certain severe symptoms, such as hallucinations and motor abnormalities, than were the unipolar patients, but the family histories of the four sub-groups were identical. The psychotic sub-groups had a different course of illness, in that they were less likely to have had a history of multiple episodes on admission and were more likely to show chronicity for a period of time on discharge. The data are interpreted as being opposed to the concept of a continuum of vulnerability in the affective disorders, and as not favouring either psychotic unipolar or psychotic bipolar illnesses or schizo-affective disorder being considered autonomous. One possible interpretation of the findings is that a trait or propensity to psychosis is transmitted totally independently of the major affective illness, and that this propensity is silent or not observed when the patient is in remission.
双相情感障碍患者和单相情感障碍患者分别被分为精神病性和非精神病性亚型。与单相情感障碍患者相比，双相情感障碍精神病性患者更易出现某些严重症状，如幻觉和运动异常，但这四个亚组的家族史相同。精神病性亚组的病程有所不同，表现为入院时较少有多次发作史，出院后更易出现一段时间的慢性病程。这些数据被解读为与情感障碍中易感性连续体的概念相悖，且不支持将精神病性单相情感障碍、精神病性双相情感障碍或分裂情感性障碍视为独立疾病。对这些发现的一种可能解释是，精神病性特质或倾向完全独立于主要情感疾病进行传递，且当患者病情缓解时，这种倾向不表现或未被观察到。
