Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand

Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 02/2004; 109(1):30-7. DOI: 10.1111/j.0001-690X.2004.00208.x
Source: PubMed


The nosological status of schizoaffective disorders is still unclear. The aim of the present study was to compare ICD-10 schizoaffective disorders to schizophrenia and affective disorders with respect to the clinical picture and the long-term outcome.
Two hundred and forty-one first-admitted inpatients from the years 1980-1982 who fulfilled the ICD-10 criteria for schizophrenia, schizoaffective or affective disorders were included. Patients were examined at the time of first hospitalization and then followed-up after 15 years.
With respect to the clinical picture at the time of first hospitalization ICD-10 schizoaffective disorders were distinguishable from both schizophrenia and affective disorders. However, with respect to the long-term outcome ICD-10 schizoaffective disorders had a prognosis similar to that of affective disorders.
Differing prognosis implies that schizoaffective disorders should be distinguished from schizophrenia and suggests their subcategorization under affective disorders.

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    • "Use of chronic inpatient populations treated with neuroleptics and longstanding illness may also confound group differences. Using patients at their index inpatient admission (e.g., Bottlender et al., 2002; Jäger et al., 2004; Bredicean et al., 2011) could also be considered problematic; such studies exclude patients at the less severe spectrum of illness and chronicity of illness is not necessarily controlled with some patients already developing a deteriorating illness course (Harrow and Grossman, 1984). "
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    ABSTRACT: Background: The diagnostic and clinical overlap between schizophrenia and schizoaffective disorder is an important nosological issue in psychiatry that is yet to be resolved. The aim of this study was to compare the clinical and functional characteristics of an epidemiological treated cohort of first episode patients with an 18-month discharge diagnosis of schizophrenia (FES) or schizoaffective disorder (FESA). Methods: This study was part of the larger First Episode Psychosis Outcome Study (FEPOS) which involved a medical file audit study of all 786 patients treated at the Early Psychosis Prevention and Intervention Centre between 1998 and 2000. Of this cohort, 283 patients had an 18-month discharge diagnosis of FES and 64 had a diagnosis of FESA. DSM-IV diagnoses and clinical and functional ratings were derived and validated by two consultant psychiatrists. Results: Compared to FES patients, those with FESA were significantly more likely to have a later age of onset (p=.004), longer prodrome (p=.020), and a longer duration of untreated psychosis (p<.001). At service entry, FESA patients presented with a higher illness severity (p=.020), largely due to the presence of more severe manic symptoms (p<.001). FESA patients also had a greater number of subsequent inpatient admissions (p=.017), had more severe depressive symptoms (p=.011), and higher levels of functioning at discharge. Discussion: The findings support the notion that these might be considered two discernable disorders; however, further research is required to ascertain the ways and extent to which these disorders are discriminable at presentation and over time.
    Schizophrenia Research 03/2013; DOI:10.1016/j.schres.2013.02.036 · 3.92 Impact Factor
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    • "Recently, detailed reviews were provided by Lake and Hurwitz [54] [55]. While some studies found that schizoaffective disorder shows a favorable outcome similar to that of affective disorders [41] [83] [90], others reported an unfavorable outcome resembling that of schizophrenia [81] [103] [107] or an outcome reflecting an intermediate position between schizophrenia and the group of affective disorders [9] [28] [32] [74] [102]. How can these contrasting findings be explained? "
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    ABSTRACT: Schizoaffective disorder is a common diagnosis in mental health services. The present article aims to provide an overview of diagnostic reliability, symptomatology, outcome, neurobiology and treatment of schizoaffective disorder. Literature was identified by searches in "Medline" and "Cochrane Library". The diagnosis of schizoaffective disorder has a low reliability. There are marked differences between the current diagnostic systems. With respect to psychopathological symptoms, no clear boundaries were found between schizophrenia, schizoaffective disorder and affective disorders. Common neurobiological factors were found across the traditional diagnostic categories. Schizoaffective disorder according to ICD-10 criteria, but not to DSM-IV criteria, shows a more favorable outcome than schizophrenia. With regard to treatment, only a small and heterogeneous database exists. Due to the low reliability and questionable validity there is a substantial need for revision and unification of the current diagnostic concepts of schizoaffective disorder. If future diagnostic systems return to Kraepelin's dichotomous classification of non-organic psychosis or adopt a dimensional diagnostic approach, schizoaffective disorder will disappear from the psychiatric nomenclature. A nosological model with multiple diagnostic entities, however, would be compatible with retaining the diagnostic category of schizoaffective disorder.
    European Psychiatry 04/2011; 26(3):159-65. DOI:10.1016/j.eurpsy.2010.03.010 · 3.44 Impact Factor
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    EMC - Psychiatrie 01/2010; 7(4). DOI:10.1016/S0246-1072(10)56146-7
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