Impaired recovery in affective disorders and schizophrenia: sharing a common pathophysiology?

Excerpt

Patients with mood disorders and schizophrenia share psychotic and affective symptoms such as delusions, cognitive deficits, depression and mania. Most importantly, however, longitudinal studies have revealed a subgroup of patients which is characterized by enduring functional disability that crosses traditional diagnostic boundaries [1]. At the level of psychopathological commonalities, Angst et al. [2] described a spectrum concept of mania ranging from patients with major depression (MDD) alone, over subthreshold manic syndromes to bipolar (BD)-II and -I disorders. According to Serafini et al. [3], patients with residual depressive symptoms exhibit a longer duration of the current illness episode and more lifetime psychotic symptoms than those without residual symptoms. During inter-episodic periods of BD, manic predominant polarity, depressive symptoms and illness severity showed to be strongly associated with functional impairment [4]. In schizophrenia (SZ), a deficit subtype, including negative symptoms and diminished emotionality, is known to be related to functional impairment compared to the low-symptom group [5]. The improvement of residual symptoms by developing pathophysiology-based treatment strategies may thus foster functional recovery in patients with affective psychoses and SZ. …