Bipolar versus schizoaffective disorder: Clinical profiles

Introduction Differentiating between bipolar (BD) and schizoaffective disorder (SAD) can be challenging, especially during early stages of the illness. Objectives Comparing clinical profiles and socio-demographic characteristics of patients diagnosed with BD and SAD. Methods The study, conducted between 2014–2016, included 67 inpatients from the Timisoara Psychiatric Clinic, diagnosed with either BD ( n  = 35) or SAD ( n  = 32), according to ICD-10 criteria. The following parameters were analyzed: number of episodes, number of times hospitalized, onset age, frequency and nature of psychotic symptoms, family history of psychiatric disorders and socio-demographic characteristics (age, sex, marital status). Data were obtained by direct interview and patient files. Symptom severity was measured with Brief Psychiatric Rating Scale (BPRS). Results There were no significant differences between the two samples regarding age or sex distribution. Schizoaffective patients were more frequent unmarried ( P  = 0.007). Onset age was significantly lower in SAD patients (22.41 years for SAD, 28.36 years for BD). SAD patients had the highest number of episodes and needed more frequent hospitalization. Bipolar patients had higher percentage of family history of affective disorders when compared to schizoaffective patients (41% versus 36%). Hallucinations were more frequently found in schizoaffective patients than in bipolar patients ( P  = 0.004). We found no significant differences between the two samples regarding the presence or the type of delusions. The SAD sample had significantly higher BPRS total scores than bipolar patients ( P  = 0.035). Conclusions Although this study revealed numerous similarities between BD and SAD, it also identified differences that may be helpful in establishing the correct diagnosis.