Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-18T20:12:10.912Z Has data issue: false hasContentIssue false
  • English
  • Français

Schizophrenia–schizoaffective–bipolar spectra: an epistemological perspective

Published online by Cambridge University Press:  28 October 2019

João Gama Marques Open the ORCID record for João Gama Marques [Opens in a new window]  and
Sílvia Ouakinin
João Gama Marques*
Affiliation:
Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal
Sílvia Ouakinin
Affiliation:
Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
*
*Author for correspondence: João Gama Marques, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

For decades clinicians and researchers have been thinking and writing about the spectrum of schizophrenia disorders. Indeed both Kraepelin and Bleuler believed in schizophrenia as a spectrum, both in a clinical (individual) and hereditary (family) continuum, from just some exquisite personality traits to unquestionable chronic and debilitating psychosis. Other authors would put the schizophrenia spectrum disorders on different levels of continuum: developmental, psychofunctional, existential, and genetic. Here, we would like to present an historical chronology for the schizophrenia–schizoaffective–bipolar spectra plus a tridimensional model for these spectra: the first axis for categories (affective versus nonaffective psychoses), the second axis for dimensions (personality versus full blown psychosis), and a third axis for biomarkers (remission versus relapse). We believe that without the schizophrenia–schizoaffective–bipolar spectra concept in our minds all our efforts will keep failing one the hardest quest: searching for biomarkers in schizophrenia and related disorders.

Keywords

Schizophreniaschizoaffectivebipolarspectrumpsychosis
Type
Perspective
Information
CNS Spectrums , Volume 26 , Issue 3 , June 2021 , pp. 197 - 201
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Garrabé, J. Histoire de la Schizophrénie. Paris: Seghers; 1992.Google Scholar
Berrios, G, Rogelio, L, Villagrán, JM. Schizophrenia: a conceptual history. Int J Psychol Psychol Ther. 2003;3:112–140.Google Scholar
Zilborg, G, Henry, GW. A History of Medical Psychology. New York: W. W. Norton; 1941.Google Scholar
Pinel, P. Traité Médico-Philosophique sur L’aliénation Mentale; ou la Manie. Paris: Chez Richard, Caille et Ravier; 1801.Google Scholar
Morel, BA. Études Cliniques: Traité, Théorique et Pratique des Maladies Mentales. Nancy: Grimblot et Veuve Raybois, Imprimeurs-Libraires; 1852; vol 1.Google Scholar
Pick, A. Ueber primäre chronische Demenz (so. Dementia praecox) im jugendlichen Alter. Prager medicinische Wochenschrift. 1891;16:312–315.Google Scholar
Kraepelin, E. Psychiatrie. 5th ed. Leipzig: Barth; 1896.Google Scholar
Minkowski, E. La Génése de la notion de schizophrénie et ses caractères essentiels. Evol Psychiatr. 1925;1:193–236.Google Scholar
Bleuler, E. Dementia Praecox, oder, Gruppe der Schizophrenien. Leipzig: Franz Deuticke; 1911.Google Scholar
McNally, K. Eugene Bleuler’s four As. Hist Psychol. 2009;12(2):43–59.Google Scholar
Arantes-Gonçalves, F, Gama Marques, J, Telles-Correia , D. Bleuler’s psychopathological perspective on schizophrenia delusions: towards new tools in psychotherapy treatment. Front Psychiatry. 2018;9:306. doi: 10.3389/fpsyt.2018.00306.Google Scholar
Heinz, A, Voss, M, Lawrie, SM, et al. Shall We Really Say Goodbye To First Rank Symptoms? Eur Psychiatry. 2016;37:8–13. doi: 10.1016/j.eurpsy.2016.04.010.Google Scholar
Soares-Weiser , K, Maayan, N, Bergman, H, et al. First Rank Symptoms For Schizophrenia. Cochrane Database Syst Rev. 2015;1:CD010653. doi: 10.1002/14651858.CD010653.pub2.Google Scholar
Marneros, A. Schizophrenic first-rank symptoms in organic mental disorders. Br J Psychiatry. 1988;152:625–628.Google Scholar
Falkai, P. Differential diagnosis in acute psychotic episode. Int Clin Psychopharmacol. 1996;11 Suppl 2:13–17.Google Scholar
Hambidge, D. Comment on A systematic review of the prevalence of schizophrenia. PLoS Med. 2005;2(9):e279; author reply e300.Google Scholar
Sachdev, PS, Keshavan, MS. Secondary Schizophrenia. Cambridge: Cambridge University Press; 2010.Google Scholar
Gama Marques, J. Raising awareness about secondary schizophrenia. Acta Med Port. 2019;32(2):169. doi: 10.20344/amp.11935.Google Scholar
Plum, F. Prospects for research on schizophrenia. 3. Neurophysiology. Neurosci Res Program Bull. 1972;10(4):456–67.Google Scholar
Kety, SS. From rationalization to reason. Am J Psychiatry. 1974;131(9):957–963.Google Scholar
Ciompi, L, The natural history of schizophrenia in the long term. Br J Psychiatry. 1980;136:413–420.Google Scholar
Strömgren, E. Development of the concept of schizophrenia. In Wing, J and Wind, L, eds. Psychoses of Uncertain Aetiology. Cambridge: Cambridge University Press; 1982.Google Scholar
Boyle, M. Schizophrenia: A Scientific Delusion. London and New York: Routledge; 1990.Google Scholar
Jenner, FA, Monteiro, ACD, Zagalo-Cardoso , JA, Cunha-Oliveira , JA. Schizophrenia a Disease or Some Ways of Being Human. Sheffield: Sheffield Academic Press; 1993.Google Scholar
Crow, TJ. Is schizophrenia the price that Homo sapiens pays for language? Schizophr Res. 1997;28(2-3):127–141.Google Scholar
Weller, MP. The spectrum of schizophrenia. Postgrad Med J. 1987;63(746):1021–1024.Google Scholar
Reich, W. The spectrum concept of schizophrenia. Problems for diagnostic practice. Arch Gen Psychiatry . 1975;32(4):489–498.Google Scholar
Angst, J, Felder, W, Lohmeyer, B. Course of schizoaffective psychoses: results of a followup study. Schizophr Bull. 1980;6(4):579–585.Google Scholar
Abrams, DJ, Rojas, DC, Arciniegas, DB. Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature. Neuropsychiatr Dis Treat. 2008;4(6):1089–1109.Google Scholar
Wilson, JE, Nian, H, Heckers, S. The schizoaffective disorder diagnosis: a conundrum in the clinical setting. Eur Arch Psychiatry Clin Neurosci. 2014;264(1):29–34. doi: 10.1007/s00406-013-0410-7.Google Scholar
Owen, MJ, Craddock, N, Jablensky, A. The genetic deconstruction of psychosis. Schizophr Bull. 2007;33(4):905–911. doi:10.1093/schbul/sbm053.Google Scholar
Cardno, AG, Owen, MJ. Genetic relationships between schizophrenia, bipolar disorder, and schizoaffective disorder. Schizophr Bull. 2014;40(3):504–515. doi: 10.1093/schbul/sbu016.Google Scholar
Guloksuz, S, van Os, J. The slow death of the concept of schizophrenia and the painful birth of the psychosis spectrum. Psychol Med. 2018;48(2):229–244. doi: 10.1017/S0033291717001775.Google Scholar
Kahn, RS. Why the concept of schizophrenia is still alive and kicking. Psychol Med. 2018;48(2):247–248. doi: 10.1017/S0033291717002069.Google Scholar
Zoghbi, AW, Lieberman, JA. Alive but not well: the limited validity but continued utility of the concept of schizophrenia. Psychol Med. 2018;48(2):245–246. doi: 10.1017/S0033291717001969.Google Scholar
Bora, E. Letter to the editor: the half-alive concept of schizophrenia is still better than the spectrum of everything. Psychol Med. 2018;48(3):519–520. doi: 10.1017/S0033291717002446.Google Scholar
Curtis, D, Derks, EM. Letter to the editor: schizophrenia does not represent the extreme of a normally distributed trait. Psychol Med. 2018;48(3):521–522. doi: 10.1017/S0033291717002422.Google Scholar
Lawrie, SM. “Schizophrenia” is a useful concept. BMJ. 2016;352:i1046. doi: 10.1136/bmj.i1046.Google Scholar
McGlashan, TH, Fenton, WS. Classical subtypes for schizophrenia: literature review for DSM-IV . Schizophr Bull. 1991;17(4):609–632.Google Scholar
Basov, AM. Clinical independence of cenestopathic schizophrenia. Zh Nevropatol Psikhiatr Im S S Korsakova. 1980;80(4):586–592.Google Scholar
Jargin, S. Some aspects of psychiatry in Russia. Int J Cult Ment Health. 2011;4(2):116–120. doi:10.1080/17542863.2010.519485.Google Scholar
Ravindran, AV, Yatham, LN, Munro, A. Paraphrenia redefined. Can J Psychiatry. 1999;44(2):133–137.Google Scholar
Bolinskey, PK, Smith, EA, Schuder, KM, et al. Schizophrenia spectrum personality disorders in psychometrically identified schizotypes at two-year follow-up . Psychiatry Res. 2017;252:289–295. doi: 10.1016/j.psychres.2017.03.014.Google Scholar
Kleist, K. Die klinische Stellung der Motilitatspsychosen (Vortrag auf der Versammlung des Vereins bayerischer Psychiater, Munchen, 6.-7-6-1911). Z Gesamte Neurol Psychiatr. 1911;3:914–977.Google Scholar
Stahl, SM, Morrissette, DA, Faedda, G, et al. Guidelines for the recognition and management of mixed depression. CNS Spectr. 2017;22(2):203–219. doi: 10.1017/S1092852917000165.Google Scholar
Vázquez, GH, Lolich, M, Cabrera, C, et al. Mixed symptoms in major depressive and bipolar disorders: a systematic review. J Affect Disord. 2018;225:756–760. doi: 10.1016/j.jad.2017.09.006.Google Scholar
Akiskal, HS, Pinto, O. The evolving bipolar spectrum: Prototypes I, II, III, IV. Psychiatr Clin North Am. 1999;22(3):517–534, vii.Google Scholar
Akiskal, HS, Mallya, G: Criteria for the “soft” bipolar spectrum: treatment implications. Psychopharmacol Bull. 1987;23(1):68–73.Google Scholar
Kasanin, J. The acute schizoaffective psychoses. 1933. Am J Psychiatry . 1994;151(6 Suppl):144–154.Google Scholar
Carloni, G, Spadoni, A. On the opportunity of preserving and limiting the use of the term “schizomania”. Riv Sper Freniatr Med Leg Alien Ment. 1959;83:1070–1078.Google Scholar
van Os, J, Takei, N, Castle, DJ, Wessely, S, Der, G, Murray, RM. Premorbid abnormalities in mania, schizomania, acute schizophrenia and chronic schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 1995;30(6):274–278.Google Scholar
Stahl, SM. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 4th ed. New York: Cambridge; 2013.Google Scholar
Leonhard, K. The Classification of Endogenous Psychoses. 5th ed. New York: Irvington Publishers; 1979.Google Scholar
Zaudig, M. Cycloid psychoses and schizoaffective psychoses – a comparison of different diagnostic classification systems and criteria. Psychopathology. 1990;23(4–6):233–242.Google Scholar
Pfuhlmann, B, Jabs, B, Althaus, G, et al. Cycloid psychoses are not part of a bipolar affective spectrum: results of a controlled family study. J Affect Disord . 2004;83(1):11–19.Google Scholar
Jabs, B, Stöber, G, Pfuhlmann, B. Cycloid Psychoses: clinical symptomatology, prognosis, and heredity. Psilogos. 2007;4(1–2):10–16.Google Scholar
van de Kerkhof, NWA, Fekkes, D, van der Heijden, FMMA, Hoogendijk, WJG, Stöber, G, Egger, JIM, Verhoeven, WMA. Cycloid psychoses in the psychosis spectrum: Evidence for biochemical differences with schizophrenia. Neuropsychiatr Dis Treat. 2016;12:1927–1933. doi: 10.2147/NDT.S101317.Google Scholar
Mitsuda, H. The concept of “atypical psychoses” from the aspect of clinical genetics. Acta Psychiatr Scand. 1965;41(3):372–377.Google Scholar
Hatotani, N. The concept of ‘atypical psychoses’: special reference to its development in Japan. Psychiatry Clin Neurosci. 1996;50(1):1–10.Google Scholar
Zimmerman, M. The relationship between borderline personality disorder and bipolar disorder. Dialogues Clin Neurosci. 2013;15(2):155–169.Google Scholar
Slotema, CW, Blom, JD, Niemantsverdriet, MBA, Deen, M, Sommer, IEC. Comorbid diagnosis of psychotic disorders in borderline personality disorder: prevalence and influence on outcome. Front Psychiatry. 2018;9:84. doi: 10.3389/fpsyt.2018.00084.Google Scholar
D’Agostino, A, Rossi Monti, M, Starcevic, V. Psychotic symptoms in borderline personality disorder: an update. Curr Opin Psychiatry. 2019;32(1):22–26. doi: 10.1097/YCO.0000000000000462.Google Scholar
Malaspina, D, Owen, MJ, Heckers, S, et al. Schizoaffective disorder in the DSM-5. Schizophr Res. 2013;150(1):21–25. doi: 10.1016/j.schres.2013.04.026. Google Scholar
Peterson, DL, Webb, CA, Keeley, JW, et al. The reliability and clinical utility of ICD-11 schizoaffective disorder: a field trial. Schizophr Res. 2019;208:235–241. doi: 10.1016/j.schres.2019.02.011.Google Scholar