New study reveals hidden manic symptoms in one-fourth of schizophrenia patients

THESSALONIKI, Greece, 11 February 2025 - In a notable Genomic Press research report, researchers at the Aristotle University of Thessaloniki have uncovered a significant presence of manic symptoms in patients with schizophrenia spectrum disorders (SSDs), offering valuable insights that could reshape treatment approaches.

The rigorous peer-reviewed study, published in Brain Medicine, examined 75 stable outpatients with SSDs, revealing that more than one in four patients (26.7%) exhibited distinct manic symptoms, a finding that carries important implications for clinical practice and patient care.

"Our research demonstrates a clear association between positive symptoms and manic presentations in schizophrenia spectrum disorders," explains Professor Evangelia M. Tsapakis, lead researcher of the study. "More importantly, we found that the severity of positive symptoms could predict the presence of manic symptoms, suggesting a deeper connection between these two aspects of psychopathology."

The investigation utilized the Young Mania Rating Scale (YMRS) alongside other clinical assessment tools, finding that patients with higher scores on the Positive and Negative Syndrome Scale (PANSS) were more likely to experience manic symptoms. This correlation proved particularly strong for positive symptoms, such as hallucinations and delusions.

"Our findings suggest we may need to reevaluate how we screen for and treat schizophrenia spectrum disorders," notes Professor K.N. Fountoulakis, senior author of the study. "By identifying manic symptoms early through systematic screening, we could potentially improve treatment outcomes and reduce the economic burden on both patients and healthcare systems. This is particularly relevant for patients who may not be responding optimally to current treatment approaches."

The study's findings support a more nuanced, dimensional understanding of mental health conditions rather than strict categorical diagnoses. This perspective could lead to more personalized treatment strategies and improved patient outcomes.

The research also revealed that:

• The presence of manic symptoms significantly correlated with overall clinical psychopathology
• Language and thought disorders showed strong associations with manic presentations
• Current diagnostic approaches might be overlooking important manic components in SSD patients

These discoveries raise important questions about the current diagnostic framework and treatment approaches. Could the presence of manic symptoms indicate a distinct subtype of schizophrenia? Might some patients benefit from mood-stabilizing medications in addition to traditional antipsychotic treatments?

The research team suggests that implementing regular screening for manic symptoms in SSD patients could lead to more effective, personalized treatment approaches. This recommendation comes at a crucial time when healthcare systems worldwide are seeking more cost-effective and efficient treatment strategies.

The study, titled “Manic symptoms in schizophrenia spectrum disorders,” appears online on 11 February 2025 in Brain Medicine (Genomic Press) and is freely accessible at https://doi.org/10.61373/bm025r.0005

About Brain Medicine: Brain Medicine (ISSN: 2997-2639) is a peer-reviewed medical research journal published by Genomic Press, New York. Brain Medicine is a new home for the cross-disciplinary pathway from innovation in fundamental neuroscience to translational initiatives in brain medicine. The journal’s scope includes the underlying science, causes, outcomes, treatments, and societal impact of brain disorders, across all clinical disciplines and their interface.