Question:
Does it happen
that someone with severe bipolar
disorder gets misdiagnosed as paranoid schizophrenic? I'm not talking
about mild manic/depressive disorder but about the full-blown deal with
psychotic episodes, violence, etc. etc.
Answer:
That really should not happen with any type of trained, seasoned
diagnostician the criteria are very very different. The
bi-polar can certainly have psychotic features, to include paranoid
delusions, auditory halluncinations, etc. but the dx criteria are
really different and present quite differently to the trained
professional.One of the major differentials in Paranoid Schizophrenia vs. Bi Polar
is that P. Schizophenia typically does not include any type of major,
prolonged affectual disturbance. Bi Polar, of course, does. Affect
is usually quite appropriate and not particuliarly unusual with PC.
There is not the flattening of affect that is seen in other forms of
Schizophrenia and not the lability found in a manic episode. Schizo-Affective Disorder is another story.....personally, I think it
is probably a mixture of mood disorder with schizophrenia. These
folks also have to show noted mood disturbance during the course of
the disorder (ie., mania and/or depressive episodes)......they also
have noted hallucinations (usually auditory) and often times delusions
which last beyond the bouts of mood disorder symptoms. I've seen
psychiatrists typically medicate this disorder with a combo of
anti-psychotic meds and typically Lithium if the person can tolerate
it.
