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Annotation

Hill SK, Reilly JL, Keefe RS, Gold JM, Bishop JR, Gershon ES, Tamminga CA, Pearlson GD, Keshavan MS, Sweeney JA. Neuropsychological Impairments in Schizophrenia and Psychotic Bipolar Disorder: Findings from the Bipolar and Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Study. Am J Psychiatry . 2013 Jun 17 ; PubMed Abstract

Comments on Paper and Primary News
Primary News: Schizophrenia and Bipolar With Psychosis Share Cognition, Connectivity

Comment by:  Jose GoikoleaEduard Vieta
Submitted 18 July 2013 Posted 18 July 2013

The recent publication of two papers from the B-SNIP group in the American Journal of Psychiatry provides additional high-quality data supporting a dimensional model for psychotic disorders, different from the current Kraepelinian categorical model. These two papers focus on two different putative endophenotypes for schizophrenia and bipolar disorder, namely, cognitive performance and white matter integrity. Interestingly, both endophenotypes show quite similar results.

The work of the B-SNIP group is praiseworthy. Consisting of six centers across the United States, the group has studied quite a large sample of patients with psychotic disorders (schizophrenia, schizoaffective, and psychotic bipolar disorder) using both current categorical diagnostic criteria and a dimensional Schizo-Bipolar Scale approach. Besides that, the group assesses relatives without psychotic or affective disorders, which is essential for further understanding the underlying genetic basis and identifying endophenotypes for these disorders.

Both studies obtain similar results for each...  Read more


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Comment by:  Antonella Trotta
Submitted 5 August 2013 Posted 7 August 2013
  I recommend this paper

Despite Kraepelin’s nosological distinction between schizophrenia and bipolar disorder and the categorical classification of current diagnostic systems, recent advances indicate that there is considerable overlap between these disorders. In fact, epidemiological, genetic, and neuroimaging studies comparing schizophrenia and bipolar disorder show a complex range of pathophysiological and phenomenological similarities (Demjaha et al., 2012).

In line with previous findings, the two papers from the B-SNIP group in the American Journal of Psychiatry confirm, respectively, the role of potential cognitive and brain functioning endophenotypes in schizophrenia and bipolar disorder. The findings of Hill and colleagues on cognitive impairment in schizophrenia and psychotic bipolar disorder add an important contribution to a continuum model of cognitive deficits in psychotic disorders in which, on one hand, schizophrenia is characterized by the most severe cognitive impairment, and bipolar disorder, on the other hand, shows less severe...  Read more


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Primary News: Schizophrenia and Bipolar With Psychosis Share Cognition, Connectivity

Comment by:  Ole A. Andreassen, SRF AdvisorMartin Tesli
Submitted 3 September 2013 Posted 4 September 2013

The two reports from the B-SNIP consortium elegantly address Kraepelin’s dichotomy in psychosis and provide evidence using a large sample that there are overlapping cognitive deficits across psychotic bipolar disorder and schizophrenia (Hill et al., 2013), and similar patterns of connectivity abnormalities (as measured by diffusion tensor imaging, or DTI) in the two disorders (Skudlarski et al., 2013). Both phenotypes are also found in relatives, supporting the idea that the cognitive and DTI measures are true "endophenotypes."

The finding that cognitive dysfunction in schizophrenia and psychotic bipolar disorder depends more on psychosis than a diagnostic group is a nice replication of our previous findings (Simonsen et al., 2011). This is reassuring and further suggests that it is a robust phenomenon, as the neuropsychological test batteries used in the two studies were quite different. The severity of the deficits is also...  Read more


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