Definition: A condition which has features of both schizophrenia and mood disorders.
Less common than schizophrenia. No data figures for the UK.
Commonly presents in early adulthood.
Woman are more affected.
Diagnosed when the patient meets the full criteria for both a mood disorder and schizophrenia. Delusions or hallucinations need to be present for min 2weeks when the mood symptoms are not present.
It can be divided into:
- manic/bipolar-type (when a manic or mixed episode occurs)
- depressed type (when illness has mainly depressive episodes)
Divided into major depressive episode, manic episode, mixed episode, and schizophrenia:
Major depressive episode
Five of the following present for min 2 weeks. One symptom must be either depressed mood or loss of interest/pleasure
- Depressed mood* *compulsory trait
- Loss of interest*
- Weight loss or weight gain
- Insomnia or hypersomnia
- Psychomotor agitation
- Feelings of guilt or worthlessness
- Decreased concentration
- Suicidal notions or thoughts of death
Persistent elevated or irritable mood for min one week. 3 of the following must be present:
- Inflated self-esteem or grandiosity
- Reduced need for sleep
- Pressure of speech
- Flight of ideas
- Easily distractible
- Excessive involvement in high risk activities e.g. huge shopping sprees
Features of both episodes- but only for one week
2 or more of the following during 1 month:
- Delusions if bizarre then diagnosis can be made
- Hallucinations if a ‘running commentary’ or 2 voices, then diagnosis made.
- Speech abnormalities
- Behavioural abnormalities catatonia or disorganized
- Negative symptoms e.g lack of emotions
- Treatment of an acute exacerbation Antipsychotics
- Long-term treatment Antipsychotics + Psychological treatments (cognitive behavioural therapy, family intervention, counseling).
- Ongoing depressive symptoms Antidepressants and ECT occasionally
- Mood stabilizer Carbamezapine
The bipolar type has a better prognosis than the depressive type as the latter usually results in long term mood disturbance.