新研究表明，精神分裂症和躁郁症是同一个疾病

忧郁的兰夹克

新研究表明，精神分裂症和躁郁症是同一个疾病（英文）New research suggests schizophrenia and bipolar disorder may be the same disease PRINT FRIENDLY EMAIL STORY
AM - Tuesday, 20 January , 2009 08:21:00
Reporter: Michael Edwards
PETER CAVE: It's a hotly debated issue in the psychiatric world but there's been new research suggesting that schizophrenia and bipolar disorder may be one and the same disease.

A study of the entire Swedish population published in the British journal Lancet shows that both disorders share common genetic origins.

But the findings have divided the psychiatric community.

Michael Edwards has this report.

MICHAEL EDWARD: The Swedish study was conducted over three decades and its sample was nine-million people. It found people closely related to sufferers of bipolar and schizophrenia had an increased risk of developing both conditions.

The study's authors say the findings call for a reappraisal of the two disorders as distinct diseases. But psychiatrist professor Gordon Parker from the Black Dog Institute disagrees.

GORDON PARKER: The opposing argument is the splitting argument that these are two separate conditions and deserve to be distinguished. And I belong to the latter group.

MICHAEL EDWARD: Professor Parker says in Australia the consensus view is that bipolar and schizophrenia are two separate conditions. He says this has been the case for around 100 years. Professor Parker says the evidence supporting the view that the two are distinct, is overwhelming.

GORDON PARKER: Firstly the clinical picture for schizophrenia and bipolar disorder are different. People with schizophrenia are psychotic. People with bipolar disorder are not necessarily psychotic.

Secondly, the two conditions show quite differing natural histories and even histories with treatment. So people with schizophrenia, once they develop the psychotic condition rarely return to normal and often have deteriorating trajectories over time; so that it's very hard for them to maintain jobs and to maintain marriages and so on and so forth.

Those with bipolar disorder, people have episodes and then they tend to return completely to normal, or almost to normal, and they're much more likely to be able to maintain jobs and marriages.

And thirdly, people with schizophrenia almost invariably need anti-psychotic medication, whereas people with bipolar disorder often respond to a mood stabiliser.

MICHAEL EDWARD: Professor Parker says suggestions that the two disorders be reclassified as the same disease worry him.

He says the major concern here is that it would lead to changes to the drugs prescribed to sufferers.

GORDON PARKER: If you have bipolar disorder and you're not psychotic you may respond very well to a reasonably gentle mood stabiliser; whereas if you're put on an anti-psychotic there may be a number of major side effects.

So that's my main concern if you regard bipolar disorder as a variant of schizophrenia, that effectively many people with bipolar disorder will be over-treated and inappropriately treated.

PETER CAVE: Professor Gordon Parker from The Black Dog Institute ending Michael Edwards' report.

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GORDON PARKER: Firstly the clinical picture for schizophrenia and bipolar disorder are different. People with schizophrenia are psychotic. People with bipolar disorder are not necessarily psychotic.