ABSTRACT
OBJECTIVE: Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD: We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS: In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION: SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.
Subject(s)
Bipolar Disorder/psychology , Multivariate Analysis , Psychotic Disorders/psychology , Schizophrenia/diagnosis , Adult , Demography , Family Health , Female , Humans , Male , Middle Aged , Sociological FactorsABSTRACT
BACKGROUND: Onset-age is a stable characteristic of bipolar disorder (BPD) patients of clinical and probable psychobiological importance, but large pooled clinical samples from multiple sites employing modern diagnostic criteria to quantify onset-age remain rare. METHODS: We pooled diagnostic, demographic, and clinical data from 1566 BPD patients from six international sites (5 European, 1 US) to compare onset-ages in subgroups. RESULTS: Median+/-IQR onset in 1090 BP-I patients was 5.8 years younger than 476 BP-II cases (24.3+/-18.3 vs. 30.1+/-13.8 years; p<0.0001). Onset-age ranked: [a] BP-I men (23.0+/-12.8); [b] BP-I women (26.0+/-14.2); [c] BP-II men (29.7+/-19.1); and [d] BP-II women (30.1+/-17.5 years. Juvenile-onset (Subject(s)
Bipolar Disorder/epidemiology
, Cross-Cultural Comparison
, Adolescent
, Adult
, Age of Onset
, Bipolar Disorder/diagnosis
, Bipolar Disorder/psychology
, Child
, Cross-Sectional Studies
, Depressive Disorder, Major/diagnosis
, Depressive Disorder, Major/epidemiology
, Depressive Disorder, Major/psychology
, Europe
, Female
, Humans
, Male
, Middle Aged
, United States
, Young Adult
ABSTRACT
In a double blind study performed in psychiatric clinics the efficacy and tolerability of the new antidepressant Moclobemide was compared. Moclobemide belongs to a new class of substances called RIMA (Reversible Inhibitor of the monoamine oxidase type A). 61 patients with major depression (according to DSM-III) were either treated with Moclobemide or Fluvoxamine, a selective reuptake-inhibitor of 5-HT. The latter belongs to a class of antidepressants known for their better tolerability compared to tricyclic antidepressants. Moclobemide was as effective as Fluvoxamine but much better tolerated as shown by a lower incidence of side effects such as gastrointestinal problems or headache.
