Akademik Veri Yönetim Sistemi
2026 ANNUAL CONGRESS of the Schizophrenia International Research Society, Florence, İtalya, 25 - 29 Mart 2026, ss.880-881, (Özet Bildiri)
Background: Current psychiatric nosology reinforces the view that bipolar disorder (BD) and schizophrenia spectrum disorders (SSD) reflect distinct disease processes. However, accumulating evidence challenges this distinction. Diagnostic instability has been increasingly recognized, with some patients shifting between BD and SSD over the course of illness. Such diagnostic changes create challenges for clinical decision-making and complicate research that assumes stable diagnostic categories. Given these concerns, examining real-world patterns of diagnostic change is essential.
Methods: This study was designed as a retrospective chart review of patients regularly followed in the Mood Disorders and Psychotic Disorders Outpatient Units of the Department of Psychiatry at Dokuz Eylul University Hospital. Individuals diagnosed with BD (ICD-10: F31.0–F31.9) or SSD (ICD-10: F20.0–F20.9, F25.0–F25.9, F28, and F29) recorded between January and June of 2025 were identified. For each identified patient, all available electronic medical records - including the initial diagnostic evaluations, longitudinal follow-up notes, diagnostic entries and clinical assessments - were reviewed to determine whether diagnostic status had changed over
time. Diagnostic change was defined as any documented shift between a BD diagnosis and an SSD diagnosis. The prevalence of diagnostic change was calculated as the number of patients with a diagnostic shift divided by the total number of patients in the sample.
Results: A total of 538 patients were identified for analysis. Of these patients, 264 had a current diagnosis of BD, and 274 had a current diagnosis of SSD. Diagnostic change between BD and SSD occurred in 43 patients, yielding an overall prevalence of 8%. Retrospectively, 34 of the 274 patients with a current SSD diagnosis (12.4%) had previously been diagnosed with BD, whereas 9 of the 264 patients with a current BD diagnosis (3.4%) had previously been diagnosed with SSD.
Discussion: Our preliminary findings demonstrate that diagnostic instability between BD and SSD is not uncommon in clinical practice. This is consistent with prior literature questioning the strict categorical distinction between these diagnoses. This study emphasizes the dynamic nature of psychotic and mood disorders, estimates the prevalence of diagnostic change, and underscores the need for longitudinal and dimensional assessment approaches. These early findings highlight the necessity of future studies with larger samples and advanced methodologies to clarify the predictors of diagnostic change. Such research could improve clinical decision-making, refine psychiatric diagnostic classifications, and support more personalized care.