Differentiating schizoaffective and bipolar I disorder in first-episode psychotic mania.

Détails

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Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_E29C3850C186
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Differentiating schizoaffective and bipolar I disorder in first-episode psychotic mania.
Périodique
Schizophrenia Research
Auteur(s)
Schöttle D., Schimmelmann B.G., Conus P., Cotton S.M., Michel C., McGorry P.D., Karow A., Naber D., Lambert M.
ISSN
1573-2509 (Electronic)
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
140
Numéro
1-3
Pages
31-36
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
OBJECTIVE: This study aims to differentiate schizoaffective disorder (SAD) and bipolar-I-disorder (BD) in first-episode psychotic mania (FEPM).
METHODS: All 134 patients from an epidemiological first-episode psychosis cohort (N=786) with FEPM and an 18-month follow-up final diagnosis of SAD (n=36) or BD (n=98) were assessed with respect to pre-treatment, baseline and outcome differences. Second, patients with baseline BD who shifted (shifted BD) or did not shift to SAD (stable BD) over the follow-up period were compared regarding pre-treatment and baseline differences.
RESULTS: SAD patients displayed a significantly longer duration of untreated psychosis (DUP; effect size r=0.35), a higher illness-severity at baseline (r=0.20) and more traumatic events (Cramer-V=0.19). SAD patients displayed a significantly higher non-adherence rate (Cramer-V=0.19); controlling for time in treatment and respective baseline scores, SAD patients had significantly worse illness severity (CGI-S; partial η(2)=0.12) and psychosocial functioning (GAF; partial η(2)=0.07) at 18-months, while BD patients were more likely to achieve remission of positive symptoms (OR=4.9, 95% CI=1.8-13.3; p=0.002) and to be employed/occupied (OR=7.7, 95% CI=2.4-24.4, p=0.001). The main discriminator of stable and shifted BD was a longer DUP in patients shifting from BD to SAD.
CONCLUSIONS: It is difficult to distinguish BD with psychotic symptoms and SAD in patients presenting with FEPM. Longer DUP is related to SAD and to a shift from BD to SAD. Compared to BD, SAD had worse outcomes and higher rates of non-adherence with medication. Despite these differences, both diagnostic groups need careful dimensional assessment and monitoring of symptoms and functioning in order to choose the right treatment.
Pubmed
Web of science
Création de la notice
24/09/2012 14:36
Dernière modification de la notice
20/08/2019 17:06
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