Bipolar disorder I vs. Schizophrenia 1

Running head: Bipolar disorder I vs. Schizophrenia

Bipolar disorder I vs. Schizophrenia in a social setting

Margarete Chubbuck

Argosy University

Bipolar disorder I vs. Schizophrenia 2

Abstract

Bipolar disorder I and schizophrenia are two mental disorders that somewhat have the

same characteristics but one can be more intense than the other. This research was conducted to

determine which of the two mental disorders are more intense when subjects are put in to a social

setting. Bipolar disorder I is classified as a mood disorder when schizophrenia is classified as a

personality disorder. Included in this research paper are the methods I used for the research,

result documentation proposals, and a discussion on the disorders themselves.

Bipolar disorder I vs. Schizophrenia 3

Bipolar disorder I and schizophrenia are two very different types of mental disorders.

Schizophrenia is a psychotic disorder; subjects who have this disorder suffer from hallucinations

or delusions. According to the DSM, “Thinking may be disconnected and illogical, peculiar

behaviors may be associated with social withdrawal and disinterest” (behavenet.com). The

criteria subjects have to have when being diagnosed with this disorder are 2 or more of the

following during a one month period: delusions, hallucinations, disorganized speech, catatonic

behavior, and negative symptoms. The DSM indicates when someone has schizophrenia there is

often social or occupational dysfunction, work and interpersonal relationships are affected

negatively and not given as much attention as they need, basically neglected.

Bipolar disorder I is classified as a mood disorder and is also referred to as manic

depressive disorder. This is categorized by major mood swings or episodes of major depression.

Bipolar disorder I has to have a criteria of both manic and mixed episodes which mean that there

has to be a manic episode and a major depressive episode evident (behavenet.com). According to

the DSM, “The mood disturbance is sufficiently severe to cause marked impairment in

occupational functioning or in usual social activities or relationships with others, or to necessitate

hospitalization to prevent harm to self or others, or there are psychotic features”

(behavenet.com). Both schizophrenia and Bipolar disorder I have significant impacts on social

relationships, occupational relationships, and interpersonal relationships.

Knowing what the DSM defines both of these disorders as, how intense is bipolar

disorder compared to schizophrenic personalities in social settings? The hypothesis to this

question is that a schizophrenic personality would be much more intense in a social setting, but a

person with bipolar disorder would be more easily recognizable and intense. The following peer

reviewed articles will try to demonstrate this hypothesis.

Bipolar disorder I vs. Schizophrenia 4

Anxiety is a major symptom in patients with Bipolar disorder I according to Doron

Sagman, “co morbid anxiety tended to be more common in patients with bipolar I disorder

compared with bipolar II (Sagman, 2009). When anyone is placed in a social setting, it involves

being around other people sometimes large groups of people, people with anxiety often tense up

and are uneasy around larger groups of people and if we combine that will BPD the situation can

quickly escalate. “Overall, the presence of anxiety in patients with BPD tends to amplify or

intensify core bipolar symptoms or to aggravate other co morbid conditions. The course of the

illness and response to treatment are also adversely affected” (Sagman, 2009). Bipolar disorder is

a mood disorder and subjects with this become very depressed and often think about committing

suicide, mood disorders also lead to personality disorders overlapping with BPD, this makes this

disorder hard to diagnose and differentiate to just one disorder.

According to John M. Grohol, Psy. D., “Most people with bipolar disorder function relatively

well in normal society and manage to cope with their mood swings, even if they don’t always

keep on their prescribed medications” (Grohol).

“Schizophrenia is challenging to treat mainly because people with this disorder don’t function as

well in society and have difficulty maintaining the treatment regimen” (Grohol). Schizophrenic

personalities are therefore harder to control in a social setting if medication is not taken and kept

up with on a regular basis. Bipolar disorder on the other hand, if not treated with medication does

not tend to be as intense as schizophrenia.

There are many disorders that are attached to another, schizophrenia is attached to

obsessive compulsive disorder (OCD), according to Alexandra Bottas, M.D, “recent studies have

found that this comorbid group is burdened by a greater magnitude of cognitive deficits, negative

Bipolar disorder I vs. Schizophrenia 5

and positive symptoms, neurological soft signs, distress, dysfunction, hopelessness, depression,

suicidal ideation, and suicide attempts. A few studies have not replicated some of these findings”

(Bottas, 2009).

There has been a recent study on patients with bipolar disorder or mood disorder with

psychotic tendencies compared to patients with schizophrenia to see if they differ in any way the

results and the conclusion was this: “RESULTS: Patients with schizophrenia had poorer insight

than patients with schizoaffective disorder and patients with psychotic unipolar depression but

did not differ from patients with bipolar disorder. CONCLUSIONS: The lack of significant

differences between patients with schizophrenia and patients with bipolar disorder was not a

result of low statistical power. (Pini, Stephano, M.D. 2001). This study shows that schizophrenia

is a much more intense disorder than BPD but when looking at the patients insight to certain

aspect the two are closely related. “The severity of residual mood symptoms in bipolar patients

with personality disorders differs from that in bipolar patients without personality disorders—

even during periods of remission” (Sagman, 2009). These statements support the previously

stated hypothesis by noting that patients with schizophrenia have a harder time concentrating and

providing clear recollections. When bipolar disorder is mixed with personality disorders the

disorder is more severe, this shows that schizophrenia is much more severe than BPD.

The participants in this study will include subjects with schizophrenia disorder and

Bipolar disorder I. In order to create a control group I will also have to use subjects with out

mental disorder history to compare the two groups on how they act in a social setting. I will

randomly select 5 people with each disorder description and no mental disorder history to see

how they react in a social setting of about ten other people.

Bipolar disorder I vs. Schizophrenia 6

The inclusion criteria that would be used would be male and female subjects ranging in

ages 25 to 30 years that have existing diagnosis of bipolar disorder or schizophrenic

personalities. I would need a control group for this research study also, for example people who

do not exhibit any of the behaviors associated with the disorders so I can analyze the difference

between the two groups. I would not use any exclusion criteria because I would need to observe

both, people with the selected disorders and people without.

The instruments that I will use in this research will be a group of about ten different

people to create a social setting for the research study. I will have to use observation instruments

for this study to record how the participants react to a large volume of other people.

Subjects were put into a social environment to see how they reacted to others. The

observer stood on the side lines and recorded how subjects reacted to other people and took notes

on what behaviors subjects with schizophrenia and bipolar I disorder portrayed. Afterwards

subjects were interviewed to see how they felt about the situation and how they think they

behaved while interacting or not interacting with other people. After interviewing subjects I took

that information and compared how each category participant reacted to their environment and

what behavior they portrayed while in the social environment and compared the similarities and

differences between all three subject categories.

In order for the researcher to not have any influence on the study I was not able to tell the

subjects what exactly I was observing them for because then I would disturb how they would

actually behave if someone wasn’t observing them in a social setting. This is withholding

information from them, I was able to let them know that I was observing them and interviewing

them for research purposes only and all of the results would remain confidential and with only

Bipolar disorder I vs. Schizophrenia 7

their permission would someone that is not necessary to look at the information be able to look at

the information. Besides this ethical issue I don’t see any other problems that would arise within

this research design as long as subjects are informed of why this observation and interview is

taking place. In order to avoid this I received permission from participants at the beginning of the

research and then after obtaining permission to observe the participants at a later date so they

don’t know what day they will be observed.

The research method test that I am using will be the T-test for independent variables, this

is an inferential test. This will be a good statistical test to use because DID and bipolar disorder

are two different psychological disorders that need to be analyzed separately and then at the end

of the study come together and determine how the two relate or do not relate in a social

environment. Another statistical test that I could use is the correlation method to determine if the

two disorders correlate in a social setting. The outcome of this test would show that there is a

negative correlation between DID and bipolar disorder, that is that if people with bipolar disorder

have a better social behavior, people with DID will have a lower level of social behavior. I will

know that these results are significant because the tests apply to what I am looking to research

and if the observations are done correctly and data is input correctly the results will be accurate.

Multiple personality disorders (MPD) also referred to as dissociative identity disorders (DID)

is defined as people who “suffer from alternation of two or more distinct personality states with

impaired recall among personality states of important information” (behavenet.com). These

people create imaginary friends and find peace within these other personalities, from observation

I have found that people who create these imaginary friends create them to suppress memories

from their childhood so they do not have to deal with the trauma they have experienced during

their childhood. Bipolar disorder is a mood disorder and a person will change moods at the drop

Bipolar disorder I vs. Schizophrenia 8

of a dime they can be really high and then drop very low in their moods. This disorder requires at

least one manic or one mixed episode (behavenet.com). In a generalization these two disorders

have many characteristics in common and some characteristics even overlap and it sometimes

seems that people with MPD can have symptoms of bipolar disorder and visa versa. My

hypothesis for this research is that people with MPD are much more intense than bipolar

personalities, but when put in a social setting bipolar disorders are more easily recognizable and

intense. Currently the status of this hypothesis is looking to be accurate, people with bipolar

disorder cannot control their moods whether they are at an all time high or an all time low, this

shows when they are associating with other people in a group setting. When having

conversations with people they can be talking about something that makes them very happy and

then something is said and they become very depressed and start to isolate from others around

them.

The aspects of the research that might have affected my results would be the fact that I did

not have very many cultural backgrounds that influenced my research results, this would have

helped if I did have a diverse group of people to observe so the study could have been more

accurate at a world wide range instead of just in my community. What I did to overcome this

obstacle was looking at previous studies and research within those studies how cultural

differences affected the outcome of the research. The environment of the patients that I was

observing was a big help because they had all come from different backgrounds/socioeconomic

backgrounds so there was a variety of different ways that these people were brought up and how

it affected how they dealt with this disorder. The flaws in my research was that I didn’t have a

large group of people to observe and talk with so the results will not be considered reliable for a

larger and more diverse group of people. In future studies researchers could make sure that there

Bipolar disorder I vs. Schizophrenia 9

is a diverse group of people that have these disorders and make sure that there is at least one

person from each different culture in the study that way the results will pertain to a larger variety

of people and be more accurate and easily replicated.

Another direction I would like to take this research in would be how these two types of

people with this disorder are alone with no one around to analyze them, how they act in their

own environment where they feel the most comfortable. I would want to know if the symptoms

are more or less intense when they are alone. Some other variables that I would look at would be

how long each person has been living and dealing with the disorder this has a significant impact

on the study because if someone has been dealing with the disorder for 10 years and another

patient has only dealt with it for 5 years the person with more experience and knowledge would

be more informed and recognize the symptoms of the disorder. I would gather up a group of

people who have been dealing with the disorder for the same amount of time that way the results

are more accurate.

Bipolar disorder I vs. Schizophrenia 10

References:

http://behavenet.com/ Clinical capsule. Retrieved June 3, 2011.

Bottas, Alexandra, MD. (2009). Comborbidity: Schizophrenia with obsessive-compulsive

disorder. UMB Medica Psychiatric Times, Vol.26 No.4. Retrieved May 13, 2011, from

http://www.psychiatrictimes.com/display/article/10168/1402540

Pini, Stefano, MD., Ph.D., Cassano, Giovanni, B. MD., F.R.C.Psych., Dell’Osso, Liliana, MD.,

& Amador, Xavier F, Ph. D. (2001)Insight Into Illness in Schizophrenia, Schizoaffective

Disorder, and Mood Disorders With Psychotic Features. The American journal of

psychiatry.RetrievedMay13,2011,from

http://ajp.psychiatryonline.org/cgi/content/abstract/158/1/122

Sagman, Doron, MD., & Tohen, Mauricio, MD. (2009). Comborbidity in the Bipolar Disorder:

The complexity of the Diagnosis and Treatment. UMB Medica Psychiatric Times, Vol. 26

No .4. Retrieved May 13, 2011, from

http://www.psychiatrictimes.com/bipolar-disorder/content/article/10168/1391541?

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