title: Comparing the prodrome of schizophrenia-spectrum psychoses and affective disorders with and without psychotic features.
abstract: OBJECTIVE
  Following encouraging results in the early detection of psychotic disorders, interest in the early detection of affective, especially bipolar disorders, has recently been renewed. However, the differentiation between affective disorders with and without psychotic features is often missing, although it has been suggested that affective disorders with psychotic features may be distinct from those without psychotic features and closely linked to non-affective psychoses.
  
  
  METHODS
  We compared the prodromal symptoms of patients who had sought help at an early detection center; had been assessed at baseline with the Structured Interview for Prodromal Syndromes (SIPS); and who, within 53 months on average, developed schizophrenia-spectrum psychosis (pre-SCZ; n=51), affective disorder with psychotic features (pre-AD-P; n=7), or affective disorder without psychotic features (pre-AD-noP; n=16).
  
  
  RESULTS
  While pre-SCZ scored slightly higher on most positive symptoms than pre-AD, pre-AD-P and pre-SCZ scored comparably across the SIPS; moreover, pre-AD-noP and pre-SCZ differed on most subscales and items, particularly on the positive and negative dimensions. Furthermore, pre-AD-P scored higher on positive symptoms than pre-AD-noP.
  
  
  CONCLUSIONS
  Our results suggest that, in the early detection of affective disorders, those that might take on a psychotic form and those with a non-psychotic course need to be considered separately. While the current at-risk criteria for psychosis function well in detecting those with a psychotic course, those with a non-psychotic course would benefit from the development and evaluation of new at-risk criteria and new early detection instruments.
authors.affiliation: University Hospital of Child and Adolescent Psychiatry, University of Bern, Bolligenstr. 111, 3000 Bern 60, Switzerland. Frauke.schultze-lutter@kjp.unibe.ch
authors.forename: Frauke
authors.initials: F
authors.lastname: Schultze-Lutter
authors.forename: Benno G
authors.initials: BG
authors.lastname: Schimmelmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: Stephan
authors.initials: S
authors.lastname: Ruhrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000175:diagnosis*; D001714:Bipolar Disorder / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology