On Mon, 5 Dec 2005, Annette Taylor, Ph. D. went:
This week we covered psychopathology in class and as we discussed
bipolar disorder he announced in class that he has biploar
disorder. Well, then he went on to make the blanket statement to the
whole class that in the manic phase he becomes schizophrenic! I
didn't want the whole class to believe this so I tried to suggest
that he was misinterpreting something but he was adamant that his
therapist said it was so.
It sounds as if his therapist was putting things into lay language for
him. You could explain that the DSM-IV has a category called Manic
Episode with Psychotic Features (described on p. 380 of the paperback
edition of the DSM-IV; I don't have DSM-IV-TR), and that it's
definitely categorized among the Mood Disorders. You could go on to
show that the diagnostic criteria for Schizophrenia specify that
you're only called schizophrenic after "Mood Disorder with Psychotic
Features has been ruled out." The key is whether the psychotic
symptoms occur exclusively during the course of a manic episode.
I think I'd want to talk about it with the student before telling the
class!
--David Epstein
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