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Similitudes y diferencias transversales entre esquizofrenia, trastorno esquizoafectivo y manía o manía mixta con rasgos psicóticos incongruentes con el estado de ánimo
Published online by Cambridge University Press: 12 May 2020
Resumen
Objetivo.
– La diferenciación clínica transversal de la esquizofrenia o el trastorno esquizoafectivo de la manía psicótica incongruente con el estado de ánimo o la manía mixta es difícil, ya que faltan síntomas patognomónicos en estos trastornos.
Propósitos del estudio.
– Comparar una serie de variables clínicas relacionadas con el estado de ánimo y la cognición en grupos de pacientes con diagnóstico del DSM-III-R de esquizofrenia, trastorno esquizoafectivo, manía psicótica incongruente con el estado de ánimo y manía mixta psicótica incongruente con el estado de ánimo.
Métodos.
– Se evaluó a 151 pacientes consecutivos en la semana anterior al alta utilizando la Entrevista Clínica Estructurada para el DSM-III-R, edición del paciente (SCID-P). La gravedad del trastorno psicopatológico se evaluó por la versión de 18 elementos de la Escala de Evaluación Psiquiátrica Breve (BPRS) y los síntomas negativos, por la Escala para la Evaluación de los Síntomas Negativos (SANS). El nivel de insight se evaluó con la Escala para Evaluar el Desconocimiento de los Trastornos Mentales (SUMD).
Resultados.
– No hubo diferencias en las tasas de tipos específicos de ideas delirantes y alucinaciones entre los sujetos con esquizofrenia, trastorno esquizoafectivo, manía psicótica y manía mixta psicótica. Las puntuaciones de los factores de la SANS fueron significativamente más altas en los pacientes con esquizofrenia que en los grupos bipolares. Los pacientes con estado mixto puntuaron significativamente más alto en depresión y excitación comparado con el grupo de esquizofrenia y, en menor medida, el grupo esquizoafectivo. Los sujetos con esquizofrenia mostraron puntuaciones más altas en la SUMD, indicando que su compromiso en la dimensión de insight era mucho mayor que el de los sujetos con manía psicótica o manía mixta.
Conclusión.
– Los síntomas negativos más bien que los afectivos pueden ser un constructo útil para diferenciar entre la esquizofrenia o los trastornos esquizoafectivos y la manía psicótica o la mixta incongruente con el estado de ánimo.
Keywords
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- Copyright © European Psychiatric Association 2004
References
Bibliografía
Akiskal, H.S., Puzantian, V.R.Psychotic forms of depression and mania. Psychiatr Clin North Am 1979;2:419–39.10.1016/S0193-953X(18)30987-0CrossRefGoogle Scholar
Akiskal, H.S., Bourgeois, M.L., Angst, J., Post, R., Moller, H.J., Hirschfeld, R. Re-evaluating the prevalence of and diagnostic composition wit hin the bread clinical spectrum of bipolar disorders. J Affect Discord 2000;59:S5–S30.10.1016/S0165-0327(00)00203-2CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: Ameritan Psychiatric Press; 1994. p. 378–81.Google Scholar
Akiskal, H.S.The temperamental borders of affective disorders. Acta Psychiatr Scand Suppl 1994;379:32–7.10.1111/j.1600-0447.1994.tb05815.xCrossRefGoogle ScholarPubMed
Amador, X.F., Strauss, D.H., Yale, S.A., Flaum, M.M., Endicott, J., Gorman, J.M.Scale to assess unawareness of a mental disorder. Assessment of insight in psychosis. Am J Psychiatry 1993;150:873–9.Google ScholarPubMed
Amador, X.F., Flaum Michael, Andreasen, N.C., Straus, D.H., Yale, S.A., Clark, S.C., et al.Awareness of illness in schizophrenia and schizoaffective and mood disorders. Arch Gen Psychiatry 1994;51:826–36.10.1001/archpsyc.1994.03950100074007CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistic al manual of mental disorders, rev. 3rd ed. Washington, DC: American Psychiatric Press; 1987.Google Scholar
Andreasen, N.C.Negative symptoms predictive of schizophrenia: definition and reliability. Arch Gen Psychiatry 1982;39:784–9.10.1001/archpsyc.1982.04290070020005CrossRefGoogle Scholar
Andreasen, N.C., Akiskal, H.S.The specificity of Bleulerian and Schneiderian symptoms: a critical reevaluation. Psychiatr Clin North Am 1983;6:41–54.10.1016/S0193-953X(18)30839-6CrossRefGoogle ScholarPubMed
Atre-Vaidya, N., Taylor, A.M.Differences in prevalence of psychosensory features among schizophrenic, schizoaffective, and maniac patients. Compr Psychiatry 1997;38:88–92.10.1016/S0010-440X(97)90086-9CrossRefGoogle Scholar
Azorin, J.M., Pupeschi, G., Valli, M., Joanny, P., Raocules, D., Lancon, C., et al.Plasma 3-methoxy-4-hydroxyphenylglycol in manic patients: relationships with clinical variables. Acta Psychiatr Scand 1990;81:14–8.10.1111/j.1600-0447.1990.tb06442.xCrossRefGoogle ScholarPubMed
Bunney, W., Goodwin, F.K., Murphy, D.L.The switch process in manicdepressive illness. Arch Gen Psychiatry 1972;27:295–1217.10.1001/archpsyc.1972.01750270005001CrossRefGoogle Scholar
Benabatre, A., Vieta, E., Colom, F., Martinez-Aran, A., Reinares, M., Gasto, C. Bipolar disorder, schizoaffective disorder and schizophrenia: epidemiologic, clinical and prognostic differences. Eur Psychiatry 2001;16:167–72.10.1016/S0924-9338(01)00559-4CrossRefGoogle Scholar
Cassano, G.B., Pini, S., Saettoni, M., Rucei, P., Dell’Osso, L. Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders. J Clin Psychiatry 1998;59:60–8.10.4088/JCP.v59n0204CrossRefGoogle ScholarPubMed
Cassidy, F., MeEvoy, J.P., Yang, Y.K., Wilson, W.H.Insight is greater in mixed than in puré manic episodes of bipolar I disorder. J Nerv Ment Dis 2001;189(ó):398–9.CrossRefGoogle ScholarPubMed
Coryell, W., Endicott, J., Keller, M. Rapidly eyeling affective disorder. [31] Demographics, diagnosis, fanuly history, and course. Arch Gen Psychiatry 1992;49:126–31.10.1001/archpsyc.1992.01820020046006CrossRefGoogle ScholarPubMed
Dilsaver, S.C., Chen, Y.W., Swann, A.C., Shoaib, A.M., Tsai-Dilsaver, Y., Krajewski, K.J.Suicidality, panic disorder and psychosis in bipolar depression, depressive-mania and pure-mania. Psychiatry Res 1997;14:47–56.10.1016/S0165-1781(97)00109-1CrossRefGoogle Scholar
Dayer, A., Aubry, J.M., Roth, L., Ducrey, S., Bertschy, G. A theoretical reappraisal of mixed States: dysphoria as a third dimensión. Bipolar Disord 2000;2:316–24.10.1034/j.1399-5618.2000.020404.xCrossRefGoogle ScholarPubMed
Dell’Osso, L., Akiskal, H.S., Freer, P., Barberini, M., Placidi, G.F., Cassano, G.B.Psychotic and non psychotic bipolar mixed states: comparisons with manic and schizoaffective disorders. Eur Arch Psychiatry Clin Neurosci 1993;243:75–81.10.1007/BF02191568CrossRefGoogle Scholar
Dell’Osso, L., Pini, S., Tundo, A., Sarno, N., Musetti, L., Cassano, G.B.Clinical characteristics of mania, mixed mania, and bipolar depression with psychotic features. Compr Psychiatry 2000;41:242–7.10.1053/comp.2000.7432CrossRefGoogle Scholar
Dell’Osso, L., Pini, S., Cassano, G.B., Mastrocinque, C., Seckinger, R.A., Saettoni, M., et al.Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features. Bipolar Disord 2002;4(5):315–22.CrossRefGoogle Scholar
Endicott, J., Spitzer, R.L., Fleiss, J.L., Cohén, J. The global assessment [37] scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976;33:766–71.10.1001/archpsyc.1976.01770060086012CrossRefGoogle ScholarPubMed
Freeman, M.P., McElroy, S.L.Clinical picture and etiologic models of mixed states. Psychiatr Clin North Am 1999;22:535–46.CrossRefGoogle ScholarPubMed
Galynker, I., Ieronimo, C., Perez-Acquino, A., Lee, Y., Winston, A. Panic attacks with psyctotic features. J Clin Psychiatry 1996;57:402–6.Google ScholarPubMed
Mackinnon, D.F., McMahahon, F.J., Simpson, S.G., et al.Panic disorder with familial bipolar disorder. Biol Psychiatry 1997;42:90–5.CrossRefGoogle ScholarPubMed
McElroy, S.L., Keck, P.E., Pope H.G.I., Hudson, J.I., Faedda, G.L., Swann, A.C.Clinical and research implication of the diagnosis of dysphoric or mixed mania or hypomania. Am J Psychiatry 1992;149:1633–44.Google ScholarPubMed
Overall, J.E., Gorham, D.R.The brief psychiatric rating scale. Psychol Rep 1962;10:799.CrossRefGoogle Scholar
Pini, S., Cassano, G.B., Dell’Osso, L., Amador, X.E.Insight into illness in schizophrenia, schizoaffective disorder, and mood disorders with psychotic features. Am J Psychiatry 2001; 158:122–5.CrossRefGoogle ScholarPubMed
Pini, S., Cassano, G.B., Simonini, E., Savino, M., Russo, A., Montgomery, S.A.Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia. J Affect Disord 1997;42:145–53.CrossRefGoogle ScholarPubMed
Pini, S., Dell’Osso, L., Mastrocinque, C., Marcacci, G., Papasogli, A., Vignoli, S., et al.Axis I comorbidity in bipolar disorder with psychotic features. Br J Psychiatry 1999;175:467–71.CrossRefGoogle ScholarPubMed
Pitchot, W., Ansseau, M., Gonzales Moreno, A., Hansenne, M., von Frenckell, R. Dopaminergic function in panic disorder: comparison with major and minor depression. Biol Psychiatry 1992;32:1004–11.CrossRefGoogle ScholarPubMed
Pope, H.G., Lipinski, J.F.Diagnosis in schizophrenia and manic depressive illness: a reassessment of the specificity of schizophrenic symptoms in the light of current research. Arch Gen Psychiatry 1978;35:811–28.CrossRefGoogle ScholarPubMed
Reddy, R., Mukherjee, S., Schnur, D.B.Comparison of negative symptomsm schizophrenic and poor outeome bipolar patients. Psychol Med 1992;22:361–5.CrossRefGoogle Scholar
Rossi, A., Daneluzzo, E., Arduini, L., Di Domenico, M., Stratta, P., Petruzzi, C. Cognitive symptoms of mania in puré and mixed episodes evaluated with the positive and negative syndrome scale. Eur Arch Psychiatry Clin Neurosci 2000;250:254–6.CrossRefGoogle ScholarPubMed
Sax, K.W., Strakowski, S.M., McElroy, S.L., Keck, P.E. Jr, West, S.A.Attention and formal thought disorder in mixed and puré mania. Biol Psychiatry 1995;37:420–3.CrossRefGoogle ScholarPubMed
Schurhoff, F., Bellivier, F., Jouvent, R., Mouren-Simeoni, M.C., Bouvard, M., Allilaire, J.F., et al.Early and lote onset bipolar disorders: two different forms of manic-depressive illness? J Affect Disord 2000;58:215–21.CrossRefGoogle Scholar
Shoiab, A.M., Dilsaver, S.C.Panic disorder in subjeets with puré mania and depressive mania. Anxiety 1995;1:302–4.CrossRefGoogle Scholar
Solovay, M.R., Shenton, M.E., Holzman, P.S.Comparative studies of thought disorders I: mania and schizophrenia. Arch Gen Psychiatr 1987;44:13–20.CrossRefGoogle Scholar
Spitzer, R.L., Williams, J.B.W., Gibbon, M.Instruction manual for the structured clinical interview for DSM-III-R (SCID 4/1787 revisión). Biometrics Research Department, New York State Psychiatric Institute; 1987.Google Scholar
SPSS Versión 10.0 for Windows. Chicago, IL: SPSS Inc; 1999.Google Scholar
Taylor, M.A., Abrams, R. The phenomenology of mania: a new look at some oíd patients. Arch Gen Psychiatry 1973;30:520–2.CrossRefGoogle Scholar
Weiler, M.A., Fleisher, M.H., McArthur-Campbell, D. Insight and symptom change in schizophrenia and other disorders. Schizophr Res 2000;45:29–36.CrossRefGoogle ScholarPubMed
Yehuda, R., Southwick, S., Giller, E.L., Ma, X., Masón, J.W.Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. J Nerv Ment Dis 1992;180:321–5.CrossRefGoogle ScholarPubMed