Can a person be bipolar and schizophrenic?


This week's CNNHealth viewer question, answered today by Dr. Charles Raison of Emory University, asks whether an individual who has been diagnosed as bipolar and has a family history of schizophrenia could be schizophrenic as well as bipolar. Dr. Raison, who is an associate professor of psychiatry and behavioral sciences, offers a thoughtful answer that points out the imprecision of psychiatric diagnoses.

Dr. Raison explains that psychiatric diagnoses rely solely on the presentation and combination of symptoms, which is imprecise. He draws an informative parallel between diseases like schizophrenia and bipolar disorder and older medical conditions like pleurisy--they are all broad conditions rather than one specific disease.

Because schizophrenia and bipolar disorder have some major symptoms in common, they can be hard to differentiate. This is further complicated by the fact that people's symptoms change over time, which can make a condition that looked like bipolar at one point seem more like schizophrenia at another. While a person can't be both bipolar and schizophrenic at the same time, there are many people who have many of the disorders' symptoms but don't clearly fit either diagnosis.

The important point Dr. Raison makes at the end of his answer is that a consistent treatment plan is more important than a diagnosis. Bipolar disorder and schizophrenia respond to similar medications, so a person's symptoms can be effectively treated even without a clear diagnosis.

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