The results of a new study could completely restructure how psychosis is diagnosed in the future. The new study by Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) has identified three neurobiologically distinct biotypes that do not always match up with conventional clinical diagnosis. Findings from the study are published in the American Journal of Psychiatry.

Up to now, the gold standard for diagnosing psychosis and categorizing patients as schizophrenic, schizoaffective, and bipolar, was clinical observation. Mounting research has shown that symptom-based diagnoses of psychotic disorders are inept when it comes to capturing specific meaningful differentiations on a case to case basis. This new indicator of psychosis could possibly move diagnosis toward a more scientific, quantitative realm.

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The study included 1,872 subjects including individuals with psychosis, their first-degree relatives, and a control group. The subjects underwent electroencephalography (EEG) and magnetic resonance imaging (MRI) tests. The researchers were able to identify three distinct biotypes in the psychotic subjects. Biotype 1 had the most brain tissue damage with predominance (59%) of schizophrenia cases. Biotype 2 had poor cognitive and eye-tracking abilities but high brain wave response according to EEG; these results often correlate with individuals who are termed overstimulated and hypersensitive. Biotype 3 was the least impaired and these patients were more likely to be diagnosed with bipolar disorder (60%).

With the vacuum that exists in the research around this area, each of these biotypes could – and likely has in the past – been diagnosed as having any one of schizophrenia, schizoaffective, or bipolar disorder.  Dr. Carol Tamminga, Chair of Psychiatry at UT Southwestern stated, “Hopefully, this neurobiological examination of severe mental illness will lead to more precise, biologically meaningful diagnoses and novel treatments.”

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