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OddDuckNash99
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17 Feb 2014, 5:48 am

beneficii wrote:
Actually, people with bipolar II can still have psychotic depression.

Yes, I realize that, but I focused on mania, due to that being the defining aspect of bipolar disorder. Plus, the poster specifically was asking about the "psychotic features" label being redundant for a "bipolar-I" diagnosis. And bipolar-I is mania.


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Tawaki
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17 Feb 2014, 10:09 am

Ettina wrote:
The dividing line between schizoaffective and bipolar is said to be 'mood-incongruent' hallucinations/delusions.

Someone who's just bipolar, they may hallucinate/have delusions when they're in the middle of a severe mood episode, but the hallucinations/delusions match their mood. So if they're manic, they'll be grandiose or paranoid or both (paranoia often involves grandiosity - you'd have to be important for so many people to be out to get you, right?). If they're depressed, they'll have insulting voices or think they're dead or blame themselves to a delusional level ('I caused the Holocaust' sort of thing).

A schizoaffective person has clear manic/hypomanic and depressive episodes, but also has hallucinations/delusions that don't fit this pattern. Either they have some hallucinations/delusions when they aren't manic or depressed, or have hallucinations/delusions that don't match their mood (eg grandiose delusions when depressed). One guy I heard of had three distinct types of episodes - manic, depressed, and paranoid. The paranoid episodes were what got him the schizoaffective diagnosis.


Where I live you get one or the other diagnosis. You don't get both. Actually, the shrinks are just calling it a subtype of Schizophrenia, which I believe the DSM V was trying to do.


Bipolar can have hallucinations and delusions especially during a mania. The difference between the two diagnosis, is a bipolar who is not actively depressed or manic do not have the hallucinations/delusions. Schizoaffective people do. If you pull the antipsychotics, those problems start coming back.

So with Schizoaffective Disorder you get the mood swings which can go away, but the hallucinations/delusions still hang around even when the mood swings leave.