Bipolar disorder and schizophrenia are two distinct disorders (Current Psychiatry, March 2006). True, many bipolar patients are misdiagnosed as having schizophrenia, and some patients have overlapping symptoms of both disorders. Many patients with schizophrenia, however, have chronic persistent psychosis and negative symptoms with no mood disorder.
Also, how can the authors say that misdiagnosing bipolar disorder as schizophrenia would unnecessarily expose patients to antipsychotics instead of needed mood stabilizers? Many atypical antipsychotics work as mood stabilizers, sometimes more effectively than lithium, divalproex, or other old standards. It sounded like the authors were turning back the clock to when many bipolar patients were misdiagnosed with schizophrenia and placed on long-term haloperidol or another conventional antipsychotic.
Anthony Green, MD
Aberdeen, NJ