Medical Questions » Psychiatry Questions » Question No. 831
| Question: | For the past twelve years, my husband has been diagnosed and treated for schizophrenia. He is now seeing a psychiatrist who says he isn' t schizophrenic, but has a bipolar affective disorder. Could you please explain what this is, and why now a difference in the diagnosis? |
| Answer: | If a patient has high blood pressure, diabetes or even epilepsy, there are specific tests that a doctor can perform to confirm the diagnosis. With the vast majority of psychiatric disorders there are no specific tests available, and it is the clinical judgment of the doctor that makes the diagnosis.
There are no definite boundaries between one type of psychiatric disorder and another, and so a group of patients with one type of disorder gradually merge into a group that are classified with another disorder. It is rather like the varying colours in a rainbow, with one colour gradually merging into the next, without any definite border, but the individual colours can still be seen.
The same applies with schizophrenia and bipolar affective disorders—one tends to merge into the other.
Patients with bipolar affective disorders tend to have moods that swing rapidly from being over-happy (euphoric) to very sad (depressed). They tend to be rather eccentric in their behaviour (like schizophrenics), but their mood swings tend to be faster than those who have another psychiatric condition called cyclothymia.
The treatment of these conditions also follows a spectrum of activity, and the diagnosis is merely a guide to the types of treatments that may be tried. The change in your husband' s diagnosis may well reflect the fact that he is responding better to medications that help bipolar affective disorders than those that help schizophrenia.
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