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Similitudes y diferencias transversales entre esquizofrenia, trastorno esquizoafectivo y manía o manía mixta con rasgos psicóticos incongruentes con el estado de ánimo

Published online by Cambridge University Press:  12 May 2020

S. Pini
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
V. de Queiroz
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
L. Dell’Osso
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
M. Abelli
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
C. Mastrocinque
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
M. Saettoni
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
M. Catena
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
G.B. Cassano
Affiliation:
Departamento de Psiquiatría, Neurobiología, Farmacología y Biotecnología, Universidad de Pisa, via Roma 65, 56100Pisa, Italia
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Resumen

Objetivo.

– La diferenciación clínica transversal de la esquizofrenia o el trastorno esquizoafectivo de la manía psicótica incongruente con el estado de ánimo o la manía mixta es difícil, ya que faltan síntomas patognomónicos en estos trastornos.

Propósitos del estudio.

– Comparar una serie de variables clínicas relacionadas con el estado de ánimo y la cognición en grupos de pacientes con diagnóstico del DSM-III-R de esquizofrenia, trastorno esquizoafectivo, manía psicótica incongruente con el estado de ánimo y manía mixta psicótica incongruente con el estado de ánimo.

Métodos.

– Se evaluó a 151 pacientes consecutivos en la semana anterior al alta utilizando la Entrevista Clínica Estructurada para el DSM-III-R, edición del paciente (SCID-P). La gravedad del trastorno psicopatológico se evaluó por la versión de 18 elementos de la Escala de Evaluación Psiquiátrica Breve (BPRS) y los síntomas negativos, por la Escala para la Evaluación de los Síntomas Negativos (SANS). El nivel de insight se evaluó con la Escala para Evaluar el Desconocimiento de los Trastornos Mentales (SUMD).

Resultados.

– No hubo diferencias en las tasas de tipos específicos de ideas delirantes y alucinaciones entre los sujetos con esquizofrenia, trastorno esquizoafectivo, manía psicótica y manía mixta psicótica. Las puntuaciones de los factores de la SANS fueron significativamente más altas en los pacientes con esquizofrenia que en los grupos bipolares. Los pacientes con estado mixto puntuaron significativamente más alto en depresión y excitación comparado con el grupo de esquizofrenia y, en menor medida, el grupo esquizoafectivo. Los sujetos con esquizofrenia mostraron puntuaciones más altas en la SUMD, indicando que su compromiso en la dimensión de insight era mucho mayor que el de los sujetos con manía psicótica o manía mixta.

Conclusión.

– Los síntomas negativos más bien que los afectivos pueden ser un constructo útil para diferenciar entre la esquizofrenia o los trastornos esquizoafectivos y la manía psicótica o la mixta incongruente con el estado de ánimo.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2004

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Similitudes y diferencias transversales entre esquizofrenia, trastorno esquizoafectivo y manía o manía mixta con rasgos psicóticos incongruentes con el estado de ánimo
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