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"Apples and pears are similar, but still different things." Bipolar disorder and schizophrenia- discrete disorders or
Heinz Grunze1, Marcelo Cetkovich-Bakmas2
1Paracelsus Medical University, Nuremberg & Psychiatrie Schwäbisch Hall, Ringstrasse 1, 74523 Schwäbisch Hall, Germany.
Abstract:
Starting with the dichotomous view of Kraepelin, schizophrenia and bipolar disorder have traditionally been considered as separate entities. More recent, this taxonomic view of illnesses has been challenged and a continuum psychosis has been postulated based on genetic and neurobiological findings suggestive of a large overlap between disorders. In this paper we will review clinical and experimental data from genetics, morphology, phenomenology and illness progression demonstrating what makes schizophrenia and bipolar disorder different conditions, challenging the idea of the obsolescence of the categorical approach. However, perhaps it is also time to move beyond DSM and search for more refined clinical descriptions that could uncover clinical invariants matching better with molecular data. In the future, computational psychiatry employing artificial intelligence and machine learning might provide us a tool to overcome the gap between clinical descriptions (phenomenology) and neurobiology.
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