Fast Five Quiz: Schizophrenia Differential Diagnosis

Stephen Soreff, MD


August 11, 2020

Schizophrenia and bipolar affective disorder (manic-depressive illness) may be difficult to distinguish from each other. Patients with manic-depressive illness predominantly have disturbances in their affect or mood. Psychotic symptoms may be prominent during a mania or depression. In classic manic-depressive illness, the psychotic symptoms are congruent with mania or depression, and the person has periods of euthymia (normal mood) with no psychotic symptoms between the episodes.

Some patients have periods of psychotic symptoms as well as pronounced moods of depression or mania. In these cases, schizoaffective disorder is diagnosed. Schizoaffective disorder is a perplexing mental illness that has both features of schizophrenia and features of a mood disorder. The coupling of symptoms from these divergent conditions makes diagnosing and treating schizoaffective patients difficult.

Post-traumatic stress disorder, anxiety disorder, and obsessive-compulsive disorder rarely present with psychotic symptoms.

Learn more about schizophrenia differential diagnosis.


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