What is the difference between bipolar disorder and schizophrenia?

In the last post, we saw how:

• Undifferentiated type of schizophrenia and residual type of schizophrenia are very similar in that they do not fit into the other classes of schizophrenia.

• The prodromal phase of schizophrenia is hard to diagnose because of the similarity between normal behaviour, especially normal adolescent behaviour.

• Stabilization phase of schizophrenia is prescribed to prevent recurrence and to keep the patient in normal health.

What happens when schizophrenia starts?

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Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for three consecutive months. This month will be dedicated to Schizophrenia. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Bipolar affective disorder. We are done looking at research work done in Nigeria on schizophrenia.

In this post, we are looking at a Quora. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.

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Sub-types

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Bouffée Délirante
This also known as Acute Delusional Psychosis was named because of the presence of clinical features for less than 3 months. The features seen in this diagnostic criteria are similar to those seen in the Diagnostic and Statistical Manual. The French say this 40% of those with this diagnosis can gradually have schizophrenia.

Latent
This was first developed in the initial study of schizophrenia when the theories of the condition were still being developed. In modern practice, the patient will need to show more clinical features to be diagnosed with schizophrenia.

Latent schizophrenia has been replaced with the term borderline, schizoid and schizotypical personality disorder. The patient may act abnormally but the thoughts are not marked by delusion and hallucination.

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Bipolar Disorder and Schizophrenia

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Source

Kristain who has had many psychiatric hospitalizations explained that only BAD 1 has enough similarities with schizophrenia to be compared. The most important similarities are the fact that both conditions present psychotic features. The particular psychotic features are those of hallucination and delusions.

The main features that set them apart are the mood disorders is the way these psychotic disorders come. The psychotic features can be seen on both sides of the pole in bipolar disorder.

Psychosis is mania usually has all the features of delusion and hallucinatory symptoms in addition to the fast rate of speech that is typically seen in mania. The patient will have difficulty sleeping too alongside all the features that are seen in mania.

The hallucination and delusion in the depressive pole of bipolar disorder usually tend towards the evil self-perception of the patient's self.

In schizophrenia, the psychotic symptoms are usually there but they typically are not going to have a mood episode along with them. They typically will have auditory hallucinations or paranoid delusions. There are features of catatonia. They may have disorganized schizophrenia and have symptoms of crying or laughing suddenly. They will have other known clinical features of schizophrenia that are well known.

In schizoaffective disorder, there are features of both conditions present.

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According to Heathline.com, some clinical features set both conditions apart from themselves.

Symptoms
In Bipolar disorder, there are compelling changes in mood and the level of activity. Those who have Bipolar Disorder can have episodes of depression and mania. The features do not happen one after the other and can have periods of resolution.

When this happens the person will not be able to take on daily tasks. The features of psychosis can happen in bipolar disorder but they only happen sometimes.

The symptoms seen in schizophrenia are more severe when compared to bipolar disorder. The psychotic features in schizophrenia are more common when compared to bipolar disorder.

In schizophrenia when they experience features of disorganized thought they will have issues taking care of themselves.

Demographics
In the United States, patients that suffer from bipolar disorder make up about 2.8%. Bipolar disorder usually come in late teenage person and early adulthood.

In the United States, schizophrenia only makes up 1% of the population. In some studies, it is a little more or less but so far it is relatively rare.

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Treatment

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Non Responders
The non-response is seen in Internal medicine and Psychiatry. Many drugs are many drugs that are used to treat psychiatric conditions over the last 50 years.

With all this progress there are still some patients who will not respond to treatments. Among those who have schizophrenia about a third of them are non-responders to different forms of pharmacotherapy.

Many factors have been considered as the cause of non-response in schizophrenia. But top on that list is the fact that there are so many different types of this disorder.

The way to deal with this is to use drugs that bind to different receptors. It is also good practice to start therapy as soon as possible. Clozapine is typically used for the management of non-responsive schizophrenia but even this drug is not always effective. One study tried to compare those that had partial relapse to no relapse.

They found that the response to Clozapin e was in some way dependent on the plasma levels seen after taking this drug. It is however possible that those who still didn’t respond to increased plasma levels may have been affected by other factors.

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Questions

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• What did you learn about Schizophrenia?

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Conclusion

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• Other subtypes of schizophrenia include Acute Delusional Psychotic and latent schizophrenia that were existing in other countries outside America.
• Bipolar disorder and schizophrenia differ in their clinical features. Schizophrenia appears to be more severe.
• The non response may be very much related to the plasma levels of the medication.

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References

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• Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
• Page demarcations made with Inkscape.org
• [MedScape](
  https://www.medscape.com/viewarticle/431253_4#:~:text=Treatment%20During%20the%20Stabilization%20Phase%20of%20Schizophrenia,-The%20stabilization%20phase&text=The%20treatment%20goals%20during%20the,of%20symptoms%2C%20and%20consolidate%20remission.

)