Evaluation of Early Maladaptive Schemas and Their Role in Differentiating Patients with Schizophrenia Disorder from Patients with Bipolar I Disorder

Schizophrenia and bipolar I disorder (BID) are chronic mental illnesses. Schizophrenia usually presents with hallucinations and delusions, mostly auditory hallucinations, sometimes commanding the patient. On the other hand, bipolar disorder, which used to be classified in the class of mood disorders and is now defined as a separate class, sometimes appears with psychotic symptoms, hallucinations, and delusions. This issue makes them very similar to psychotic patients, including schizophrenia, as they sometimes have similar signs and symptoms. Thus, it isn't easy to differentiate between them. This research started with the hypothesis that patients suffering from any disorder have specific psychological structures and demands. The main purpose of this research was to investigate the differential diagnosis of schizophrenia patients from bipolar I disorder using early maladaptive schemas.

The method of this research was causal–comparative. The study's statistical population comprised patients with schizophrenia and bipolar I disorder who were hospitalized in the Ibn Sina Psychiatric Hospital in Shiraz City, Iran, from 2017 to 2018; the psychiatrists of that center diagnosed the mentioned disorders. The inclusion criteria included having a minimum education higher than the first grade of guidance school, willingness to participate in the research, and no comorbidity of the mentioned disorders with other disorders, such as substance abuse in the examined patients. Data were collected from two groups, including 60 men admitted to Ibn Sina Psychiatric Hospital in Shiraz. Thirty cases with bipolar I disorder and 30 with schizophrenia were randomly selected. Young Schema Questionnaire (Young & Brown, 1998) with 75 items was used. The questionnaire sheets were scored by the Excel file programmed for scoring. Then the scores obtained for each case were submitted to the statistical software for analysis. For data analysis, multivariate analysis of variance (MANOVA) and univariate analysis of variance (ANOVA) were performed using SPSS–26 software. The significance level for all tests was α=0.05.

The findings of the study showed that there were significant differences between patients with schizophrenia disorder and patients with bipolar I disorder in dependency/incompetence (p=0.018), failure (p=0.041), self–sacrifice (p=0.022), and autocracy (entitlement) schemas (p=0.007).

According to the study results, patients with schizophrenia have dependency/incompetence and failure schemas. Also, people with bipolar I disorder have schemas of self–sacrifice and autocracy (entitlement). These results can be used as a criterion for differential diagnosis between schizophrenia and bipolar I disorder.