Schizoaffective psychoses: Genetical clues to classification

Department of Psychiatric Demography, Aarhus University Psychiatric Hospital, Denmark.
American Journal of Medical Genetics (Impact Factor: 3.23). 02/1995; 60(1):7-11. DOI: 10.1002/ajmg.1320600103
Source: PubMed


The diagnostic classification of schizoaffective psychoses has varied much since Kasanin introduced the concept in 1933. The various classifications have agreed that schizoaffective psychoses present a combination of schizophreniform and affective symptoms, but the diagnostic criteria differ as to the number, quality, and time sequence of the symptoms even in recent classifications like RDC, DSM-III-R, and ICD-10. The classifications are syndromatical, and the etiology of the schizoaffective psychoses is still undetermined apart from evidence for a strong genetic factor. Results from family, twin, and adoption studies are divergent, but all the same, support a separate classification of broadly defined schizoaffective psychoses as possibly being phenotypical variations or expressions of genetic interforms between schizophrenia and affective psychoses.

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    • "The potential proband had to have at least one other sibling affected with the similar diagnosis according to the family history. The depressive type of schizoaffective disorder was included as the ascertainment diagnosis because it was considered as one manifestation of the schizophrenia susceptibility genes based on the data of family study [Baron et al., 1982; Kendler et al., 1986; Maier and Lichtermann, 1991; Maj et al., 1991; Bertelsen and Gottesman, 1995]. If the proband and any other affected siblings were twins, the zygosity was checked and monozygotic twins were excluded. "
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    ABSTRACT: One possible reason of the inconsistent results of linkage analyses of schizophrenia, a complex disorder, was mainly due to the small sample size of studies. This Taiwan Schizophrenia Linkage Study (TSLS) was designed to collect a large family sample with at least two affected siblings of a single ethnicity. The 17.6 millions of Taiwanese Chinese, age over 15, was the sample population, and 78 psychiatric hospitals or health centers participated in this TSLS program. Before data collection started, every study subject signed the informed consent. The ascertainment protocol for data collection included blood sample, structured Diagnostic Interview for Genetic Studies (DIGS), Structured Interview for Schizotypy (SIS), scales for assessment of positive and negative symptoms (SAPS, SANS), and continuous performance test (CPT), Wisconsin card sort test (WCST) of neuropsychological functions. We have contacted 831 families for this study and 607 families, comprised 2,490 subjects, were successfully recruited. The recruitment rate was 38.4% from the estimated total of 1,582 families with at least two affected siblings. These collected family samples were fairly evenly distributed all over Taiwan. Those 2,490 study subjects (1,283 male, 1,117 female) comprised 1,568 siblings (mean age 35.7 years old) and 922 parents (mean age 63.6 years old). Of these 1,568 siblings, 1,258 (80.2%) were affected (male 795, female 463), and the mean age of onset was 22.6 years old. Among 922 parents, 65 were affected (male 14, female 51) and the age of onset was 33.1 years old. This TSLS demonstrated a successful establishment of an efficient research infrastructure to collect a large nation-wise sample of schizophrenic family for genetic linkage study.
    Full-text · Article · Apr 2005 · American Journal of Medical Genetics Part B Neuropsychiatric Genetics
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    • "The results also shed some light on the status of schizoaffective disorder , that has long been a subject of controversy [ Kendell , 1988 ; Bertelsen and Gottes - man , 1995 ] . Clinically , this disorder shares features with both schizophrenia and affective psychoses , and the results of this study suggest that etiologically it is also a kind of genetic interform whose genetic liability is contributed to by a combination of genetic risk factors for schizophrenia and mania . "
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    ABSTRACT: Twin studies have been vital for establishing an important genetic contribution to the etiology of schizophrenia. The five newest studies since 1995 from Europe and Japan have confirmed earlier findings. They yielded probandwise concordance rates of 41-65% in monozygotic (MZ) pairs and 0-28% in dizygotic (DZ) pairs, and heritability estimates of approximately 80-85%. Twin studies are also valuable for investigating the etiological relationships between schizophrenia and other disorders, and the genetic basis of clinical heterogeneity within schizophrenia. Studies of discordant MZ pairs provide further insights into non-inherited factors that contribute to the multifactorial etiology of this disorder. More recently, twin studies have begun to be used to directly investigate molecular genetic and epigenetic processes underlying schizophrenia.
    Full-text · Article · Feb 2000 · American Journal of Medical Genetics
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    ABSTRACT: The pharmacological treatment of schizoaffective disorders (SD) is usually carried out with antipsychotics, mood stabilizers and antidepressants. There is a lack of clinical trials specifically designed to assess the clinical response of schizoaffective patients to medication. Therefore, data on the treatment of patients with SD is largely derived from datasets of patients with schizophrenia and bipolar disorders. Research data support the idea of a continuum between bipolar and schizophrenic disorders. Both disorders can be treated with antipsychotics and this may reflect a common pathophysiological diathesis.
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