Skip to main content

Advertisement

SpringerLink
Log in

Social and clinical comparison between schizophrenia and bipolar disorder type I with psychosis in Costa Rica

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Introduction

Schizophrenia (SC) and bipolar disorder (BP) are two of the most severe and incapacitating mental disorders. It has been questioned whether these two conditions designate distinct illnesses with different etiologies or whether they represent different ends of a clinical spectrum with a common etiology.

Materials and methods

This study compares social and clinical characteristics of 84 SC and 84 BP subjects from the Costa Rican Central Valley (CRCV) using information from the DIGS, FIGS and psychiatric records. Each of these subjects had a best estimate lifetime consensus diagnosis of either bipolar type I or SC.

Results

Subjects with SC differed from subjects with BP in social adjustment measures like marital and employment status, and number of children. Both groups were very similar in years of education, age of onset of their illness, history of other psychiatric co-morbidities, and treatment received.

Discussion

The high percentage of psychosis in the BP group (97.6%) may largely explain the similarities found between groups in their clinical characteristics.

Conclusion

The differences in social and functional decline support the original dichotomy described by Kraepelin based on chronicity and periodicity between these two psychotic disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agerbo E, Byrne M, Eaton WW, Mortensen PB (2004) Marital and labor market status in the long run in schizophrenia. Arch Gen Psychiatry 61:28–33

    Article  PubMed  Google Scholar 

  2. Alegria M, Mulvaney-Day N, Torres M, Polo A, Cao Z, Canino G (2007) Prevalence of psychiatric disorders across Latino subgroups in the United States. Am J Public Health 97:68–75

    Article  PubMed  Google Scholar 

  3. Aleman A, Kahn RS, Selten JP (2003) Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry 60:565–571

    Article  PubMed  Google Scholar 

  4. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  5. Andrade L, Caraveo-Anduaja JJ, Berglund P, Bijl R, Kessler RC, Demler O (2000) Cross-national comparisons of the prevalences and correlates of mental disorders. Bull World Health Organ 78:413–426

    Google Scholar 

  6. Andreasson S, Engström A, Allebeck P, Rydberg U (1987) Cannabis and schizophrenia: a longitudinal study of Swedish conscripts. The Lancet 330(8574):1483–1486

    Article  Google Scholar 

  7. Berrettini WH (2000) Are schizophrenic and bipolar disorders related? A review of family and molecular studies. Biol Psychiatry 48:531–538

    Article  CAS  PubMed  Google Scholar 

  8. Berrettini W (2003) Evidence for shared susceptibility in bipolar disorder and schizophrenia. Am J Med Genet C (Sem Med Genet) 123C:59–64

    Article  Google Scholar 

  9. Bramon E, Sham PC (2001) The common genetic liability between schizophrenia and bipolar disorder: a review. Curr Psychiatry Rep 3(4):332–337

    Article  CAS  PubMed  Google Scholar 

  10. Breslau J, Aguilar-Gaxiola S, Kendler KS, Su M, Williams D, Kessler RC (2006) Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychol Med 36:57–68

    Article  PubMed  Google Scholar 

  11. Breslau J, Lane M, Sampson N, Kessler RC (2008) Mental disorders and subsequent educational attainment in a US national sample. J Psychiatr Res 42(9):708–716

    Article  PubMed  Google Scholar 

  12. Cannon M, Jones P, Gilvarry C, Rifkin L, McKenzie K, Foerster A, Murray RM (1997) Premorbid social functioning in schizophrenia and bipolar disorder: similarities and differences. Am J Psychiatry 156(6):1544–1550

    Google Scholar 

  13. Carpenter WT, Buchanan RW (1994) Schizophrenia. N Engl J Med 330(10):681–690

    Article  PubMed  Google Scholar 

  14. Evans KL, Muir WJ, Blackwood D, Porteous DJ (2001) Nut and bolts of psychiatric genetics: building on the Human Genome Project. Trends Genet 17(1):35–40

    Article  CAS  PubMed  Google Scholar 

  15. Glahn DC, Bearden CE, Barguil M, Barrett J, Reichenberg A, Bowden CL, Soares JC, Velligan DI (2007) The neurocognitive signature of psychotic bipolar disorder. Biol Psychiatry 62:910–916

    Article  PubMed  Google Scholar 

  16. Glen T, Scott AIF (2000) Variation in rates of electroconvulsive therapy use among consultant teams in Edinburgh (1993–1996). J Affect Disord 58:75–78

    Article  CAS  PubMed  Google Scholar 

  17. Goodwin FK, Jamison KR (1990) Manic-depressive illness. Oxford University Press, New York

    Google Scholar 

  18. Greenhalgh J, Knight C, Hind D, Beverley C, Walters S (2005) Clinical and cost-effectiveness of electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania: systematic reviews and economic modeling studies. Health Technol Assess 9(9):1–156

    CAS  PubMed  Google Scholar 

  19. Hermann RC, Dorwart RA, Hoover CW, Brody J (1995) Variation in ECT use in the United States. Am J Psychiatry 152:869–875

    CAS  PubMed  Google Scholar 

  20. Hutchinson G, Bhugra D, Mallett R, Burnett R, Corridan B, Leff J (1999) Fertility and marital rates in first-onset schizophrenia. Soc Psychiatry Psychiatr Epidemiol 34:617–621

    Article  CAS  PubMed  Google Scholar 

  21. Hutchinson G, Haasen C (2004) Migration and schizophrenia. The challenges for European psychiatry and implications for the future. Soc Psychiatry Psychiatr Epidemiol 39:350–357

    Article  PubMed  Google Scholar 

  22. Instituto Nacional de Estadística y Censos (2000) Censo de población: Características Educativas y Económicas. INEC. http://www.inec.go.cr Junio 2000. San José, Costa Rica

  23. Jones PB, Rantakallio P, Hartikainen A-L, Isohanni M, Sipila P (1998) Schizophrenia as a long-term outcome of pregnancy, delivery and perinatal complications: a 28-year follow-up of the 1966 North Finland general population birth cohort. Am J Psychiatry 155:355–364

    CAS  PubMed  Google Scholar 

  24. Jones PB, Tarrant CJ (2000) Developmental precursors and biological markers for schizophrenia and affective disorders: Specificity and public health implications. Eur Arch Psychiatry Clin Neurosci 250:286–291

    Article  CAS  PubMed  Google Scholar 

  25. Keck PE Jr, McElroy SL, Rochussen Havens J, Altshuler LL, Nolen WA, Frye MA, Suppes T, Denicoff KD, Kupka R, Leverich GS, Rush AJ, Post RM (2003) Psychosis in bipolar disorder: phenomenology and impact on morbidity and course of illness. Compr Psychiatry 44(4):263–269

    Article  PubMed  Google Scholar 

  26. Kennedy N, Boydell J, Kalidindi S, Fearon P, Jones PB, van Os J, Murray RM (2005) Gender differences in incidence and age at onset of mania and bipolar disorder over a 35-year period in Camberwell, England. Am J Psychiatry 162:257–262

    Article  PubMed  Google Scholar 

  27. Kinney DK, Yurgelun-Todd DA, Tohen M, Tramer S (1998) Pre- and perinatal complications and risk for bipolar disorder: a retrospective study. J Affect Disord 50(2–3):117–124

    Article  CAS  PubMed  Google Scholar 

  28. Krebs M-O, Sautel F, Bourdel M-C, Sokoloff P, Schwartz J-C, Olie J-P, Loo H, Poirier M-F (1998) Dopamine D3 receptor gene variants and substance abuse in schizophrenia. Mol Psychiatr 3:337–341

    Article  CAS  Google Scholar 

  29. Lane A, Byrne M, Mulvany F, Kinsella A, Waddington JL, Walsh D, Larkin C, O’Callaghan E (1995) Reproductive behaviour in schizophrenia relative to other mental disorders: evidence for increased fertility in men despite decreased marital rate. Acta Psychiatr Scand 914:222–228

    Article  Google Scholar 

  30. Leckman JF, Sholomskas D, Thompson WD, Belanger A, Weissman MM (1982) Best estimate of lifetime psychiatric diagnosis: a methodological study. Arch Gen Psychiatry 39(8):879–883

    CAS  PubMed  Google Scholar 

  31. Mann JJ, Waternaux C, Haas GL, Malone KM (1999) Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 156:181–189

    CAS  PubMed  Google Scholar 

  32. McDonald C, Murray RM (2000) Early and late environmental risk factors for schizophrenia. Brain Res Rev 31(2–3):130–137

    Article  CAS  PubMed  Google Scholar 

  33. McGrath J, Saha S, Welham J, El Saadi O, MacCauley C, Chant D (2004) A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Medicine 2:13–35

    Article  PubMed  Google Scholar 

  34. Medina-Mora ME, Borges G, Benjet C, Lara C, Berglund P (2007) Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample. Br J Psychiatry 190:521–528

    Article  PubMed  Google Scholar 

  35. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC (2007) Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 64(5):543–552

    Article  PubMed  Google Scholar 

  36. Nurnberger JI Jr, Blehar MC, Kaufmann CA, York-Cooler C, Simpson SG, Harkavy-Friedman J, Severe JB, Malaspina D, Reich T (1994) Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatry 51(11):849–859

    PubMed  Google Scholar 

  37. Ritsner M, Sherina O, Ginath Y (1992) Genetic epidemiological study of schizophrenia: reproduction behaviour. Acta Psychiatr Scand 85(6):423–429

    Article  CAS  PubMed  Google Scholar 

  38. Saatcioglu O, Tom Ruk N (2008) Practice of electroconvulsive therapy at the research and training hospital in Turkey. Soc Psychiatry Psychiatr Epidemiol 43:673–677

    Article  PubMed  Google Scholar 

  39. Saha S, Chant D, Welham J, McGrath J (2005) A systematic review of the prevalence of schizophrenia. PLoS Med 2(5):e141

    Article  PubMed  Google Scholar 

  40. Sham PC, Jones P, Russell A, Gilvarry K, Bebbington P, Lewis S, Toone B, Murray R (1994) Age at onset, sex, and familial psychiatric morbidity in schizophrenia: Camberwell Collaborative Psychosis Study. Br J Psychiatry 165:466–473

    Article  CAS  PubMed  Google Scholar 

  41. Sharpley M, Hutchinson G, McKenzie K, Murray RM (2001) Understanding the excess of psychosis among the African-Caribbean population in England. Review of current hypotheses. Br J Psychiatry 40:s60–s68

    Article  CAS  Google Scholar 

  42. Seidman LJ, Kremen WS, Koren D, Faraone SV, Goldstein JM, Tsuang MT (2002) A comparative profile analysis of neuropsychological functioning in patients with schizophrenia and bipolar psychoses. Schizophr Res 53(1–2):31–44

    Article  PubMed  Google Scholar 

  43. Sibisi CD (1990) Sex differences in the age of onset of bipolar affective illness. Br J Psychiatry 156:842–845

    Article  CAS  PubMed  Google Scholar 

  44. Siegel GJ, Agranoff BW, Albers RW, Molinoff PB (1994) Basic neurochemistry, 5th edn. Raven Press, New York, p 1080

    Google Scholar 

  45. Surja AA, El-Mallakh RS (2007) Fertility and childhood bipolar disorder. Med Hypotheses 69:587–589

    Article  PubMed  Google Scholar 

  46. Tandon R, Keshavan MS, Nasrallah HA (2008) Schizophrenia, “just the facts” what we know in 2008. 2. Epidemiology and etiology. Schizophr Res 102(1–3):1–18

    Article  PubMed  Google Scholar 

  47. Thara R, Srinivasan TN (1997) Outcome of marriage in schizophrenia. Soc Psychiatry Psychiatr Epidemiol 32:416–420

    CAS  PubMed  Google Scholar 

  48. Torrey EF, Bowler AE, Taylor EH, Gottesman II (1994) Schizophrenia and manic-depressive disorder: the biological roots of mental illness as revealed by the landmark study of identical twins. Basic Books, Harper Collins Publishers, New York, p 274

    Google Scholar 

  49. Wyatt RJ, Alexander RC, Egan MF, Kirch DG (1988) Schizophrenia, just the facts: what do we know, how well do we know it? Schizophr Res 1(1):3–18

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cellular and Molecular Biology Research Center, University of Costa Rica, Sabanilla, Costa Rica

    Adriana Pacheco, Marcela Barguil, Javier Contreras & Henriette Raventós

  2. Hospital México, La Uruca, Costa Rica

    Patricia Montero

  3. University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Albana Dassori & Michael A. Escamilla

  4. School of Biology, University of Costa Rica, San Jose, Costa Rica

    Henriette Raventós

Authors
  1. Adriana Pacheco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marcela Barguil
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Javier Contreras
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patricia Montero
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Albana Dassori
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael A. Escamilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Henriette Raventós
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adriana Pacheco.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pacheco, A., Barguil, M., Contreras, J. et al. Social and clinical comparison between schizophrenia and bipolar disorder type I with psychosis in Costa Rica. Soc Psychiat Epidemiol 45, 675–680 (2010). https://doi.org/10.1007/s00127-009-0118-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-009-0118-1

Keywords

Search

Navigation