Psychiatry

Processes Similar in Schizophrenia, Psychotic Biopolar Disorder

by U.S. Medicine

September 22, 2019

NASHVILLE, TN—Processes leading to impairment in schizophrenia and psychotic bipolar disorder might be more similar than previously assumed, according to a new study.

The report in Schizophrenia Research pointed out that neuropsychological impairment is common in schizophrenia and psychotic bipolar disorder, although a common hypothesis is that pathways leading to impairment differ between the two disorders.1

The Vanderbilt University-led study, which also included involvement from the VA’s Tennessee Valley Healthcare System, sought to test several aspects of the hypothesis, which essentially suggests that cognitive impairment in schizophrenia results largely from atypical neurodevelopment, but bipolar disorder is increasingly conceptualized as a neuroprogressive disorder.

To do that, the study team assessed current neuropsychological functioning and estimated premorbid intellectual ability in 260 healthy individuals, as well as in 410 patients who represent a large, cross-sectional sample of individuals in the early and chronic stages of psychosis.

The following hypotheses were tested: 1) cognitive impairment is more severe in schizophrenia in the early stage of psychosis; and 2) cognitive decline between early and chronic stages is relatively greater in psychotic bipolar disorder.

For the study, psychosis patients were classified as either:

  • Neuropsychologically normal,
  • Deteriorated, or
  • Compromised (i.e., below average intellectual functioning).

The issue was whether neuropsychologically compromised and deteriorated patients occurred more often in schizophrenia or psychotic bipolar disorder.

Results indicated that neuropsychological impairment in the early stage of psychosis was more severe in schizophrenia, while psychotic bipolar disorder was not associated with relatively greater cognitive decline between illness stages.

Although the frequency of neuropsychologically compromised patients was higher in schizophrenia, researchers also pointed out that substantial percentages of both schizophrenia and psychotic bipolar disorder patients were classified as neuropsychologically compromised and deteriorated.

“While schizophrenia is associated with relatively greater neurodevelopmental involvement, psychotic bipolar disorder and schizophrenia cannot be strictly dichotomized into purely neuroprogressive and neurodevelopmental illness trajectories; there is evidence of both processes in each disorder,” the study authors concluded.

  1. Menkes MW, Armstrong K, Blackford JU, Heckers S, Woodward ND. Neuropsychological functioning in early and chronic stages of schizophrenia and psychotic bipolar disorder. Schizophr Res. 2019 Apr;206:413-419. doi: 10.1016/j.schres.2018.10.009. Epub 2018 Oct 26. PubMed PMID: 31104720; PubMed Central PMCID: PMC6530584.


Related Articles

Seeing Combat Can Make Aging More Difficult for Veterans

PORTLAND, OR—Being exposed to combat makes a significant difference in how military veterans fare during aging, according to a new study, which also found that the experience increases the risk for depression and anxiety later... View Article

Top VISN 7 Officials Removed After Cancer Patient Attacked by Insects

Elderly AF Veteran Had More Than 100 Ant Bites Before Death ATLANTA—Nine VA employees, including the VISN 7 director and chief medical officer, have been reassigned following reports that an elderly patient at the Atlanta... View Article


U.S. Medicine Recommends


More From psychiatry

Psychiatry

Combat PTSD/TBI Increases Amygdala Size in Military Patients

SAN DIEGO—The region of the brain that processes fear, anxiety, aggression and similar emotions is larger in veterans and active-duty service members with combat-related post-traumatic stress disorder and mild traumatic brain injury than those with... View Article

Psychiatry

Some Veterans Want Family Involved With Mental Health Treatment

LOS ANGELES—One of the most difficult issues in caring for adults with severe mental illness, including at the VA, is balancing privacy regulations with family members’ desire to be in the know. A study published... View Article

Psychiatry

VA Study Addresses Concerns About Anti-Epileptic Drugs, Suicidal Behavior Link

In 2008, the U.S. Food and Drug Administration issued an alert about increased risk for suicidal ideation and behavior for patients taking anti-epileptic drugs (AEDs).

Psychiatry

MHS Implements Multiple Programs to Improve PTSD and Depression Care

In the year since the release of a RAND report critical of follow-up within the Military Health System (MHS) for patients with post-traumatic stress disorder (PTSD) and depression, the DoD has released results of several new programs to improve screening, increase the number of therapeutic visits and track mental health measures.

Psychiatry

Most Post-9/11 Veterans Report Doing Well at Work and at Home

BOSTON – The overwhelming majority of veterans of U.S. conflicts since the terrorist attack on 9/11/2001 are nothing like the post-traumatic stress disorder (PTSD)-addled, homeless opioid-addicts too often depicted in the media and in political campaigns.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up