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Psychosis in Bipolar and Unipolar Affective Illness with Special Reference to Schizo-affective Disorder

Published online by Cambridge University Press:  29 January 2018

George Winokur
George Winokur*
Affiliation:
Department of Psychiatry, University of Iowa College of Medicine, 500 Newton Road, Iowa City, Iowa 52242, USA
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Summary

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.

Type
Lecture
Information
The British Journal of Psychiatry , Volume 145 , Issue 3 , September 1984 , pp. 236 - 242
Copyright
Copyright © 1984 The Royal College of Psychiatrists 

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References

Charney, D. & Nelson, J. (1981) Delusional and non-delusional unipolar depression—further evidence for distinct subtypes. American Journal of Psychiatry, 138, 328–333.Google Scholar
Coryell, W. & Tsuang, M. (1982) Primary unipolar depression and the prognostic significance of delusions. Archives of General Psychiatry, 39, 1181–1184.Google Scholar
Coryell, W. & Tsuang, M. & McDaniel, J. (1982) Psychotic features in major depression. Journal of Affective Disorders, 4, 227–236.Google Scholar
Feighner, J., Robins, E., Guze, S., Woodruff, R., Winokur, G. & Munoz, R. (1972) Diagnostic criteria in use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Gershon, E., Hamovit, J., Guroff, J., Dibble, E. Leckman, J. Sceery, W., Targum, S., Nurenberger, J., Goldin, L. & Bunney, W. (1982) A family history of schizoaffective bipolar I, bipolar II, unipolar and normal control probands. Archives of General Psychiatry, 39, 1157–1167.Google Scholar
Helms, P. & Smith, R. (1983) Recurrent psychotic depression—evidence of diagnostic stability. Journal of Affective Disorders, 5, 51–54.Google Scholar
Hrubec, Z. & Omenn, G. (1981) Evidence of genetic predisposition on alcoholic cirrhosis and psychosis: twin concordances for alcoholism in its biological endpoints by zygosity among male veterans. Alcoholism: Clinical and Experimental Research, 5, 207–215.Google Scholar
Morrison, J., Clancy, J., Crowe, R. & Winokur, G. (1972) The Iowa 500.1. Diagnostic validity in manic depression and schizophrenia. Archives of General Psychiatry, 27, 457–461.Google Scholar
Procci, W. (1976) Schizoaffective psychosis: fact or fiction? Archives of General Psychiatry, 33, 1167–1178.CrossRefGoogle ScholarPubMed
Rosen, L., Rosenthal, N., Dunner, D. & Fieve, R. (1983) Social outcome compared in psychotic and non-psychotic bipolar I patients. Journal of Nervous and Mental Disease, 272, 272–275.Google Scholar
Thompson, W., Orvashell, H., Prusoff, B. & Kidd, K. (1982) An evaluation of the family history method for ascertaining psychiatric disorders. Archives of General Psychiatry, 39, 53–58.Google Scholar
Tsuang, M. (1979) ‘Schizoaffective disorder’ dead or alive? Archives of General Psychiatry, 36, 633–634.Google Scholar
Tsuang, M. Woolson, R., Winokur, G. & Crowe, R. (1981) Stability of psychiatric diagnosis, schizophrenia, and affective disorders followed up over a 30 to 40 year period. Archives of General Psychiatry, 38, 535–539.Google Scholar
Waziri, R., Wilson, R. & Sherman, A. (1983) Plasma serine/cysteine ratio as a biological marker for psychosis. British Journal of Psychiatry, 143, 69–73.CrossRefGoogle Scholar
Winokur, G., Morrison, J., Clancy, J. & Crowe, R. (1972) The Iowa 500: II. A blind history comparison, mania, depression and schizophrenia. Archives of General Psychiatry, 27, 462–464.Google Scholar
Winokur, G. Tsuang, M. & Crowe, R. (1962) The Iowa 500: Affective disorder in relatives and manic depressed patients. American Journal of Psychiatry, 139, 209–212.Google Scholar
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