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Is schizoaffective disorder a useful diagnosis?

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Abstract

A diagnosis of schizoaffective disorder is frequently used to describe a psychotic person with significant symptoms of depression and/or mania. The word schizoaffective was introduced by Jacob Kasanin in 1933 and has appeared in all editions of the DSM since 1952. However, the current DSM-IV-TR diagnosis of schizoaffective disorder is not reliable and is of limited clinical utility. The validity is built primarily on the prediction of course and outcome and on emerging findings from genetic and neurobiological studies. This review of the current status of schizoaffective disorder concludes with several suggestions for a revision of the diagnosis within a categorical or dimensional nosology of psychotic and affective disorders.

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References and Recommended Reading

  1. Kasanin J: The acute schizoaffective psychoses. Am J Psychiatry 1933, 90:97–126.

    Google Scholar 

  2. Marneros A: The schizoaffective phenomenon: the state of the art. Acta Psychiatr Scand Suppl 2003, 418:29–33.

    Article  PubMed  Google Scholar 

  3. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 1. Washington, DC: American Psychiatric Association; 1952.

    Google Scholar 

  4. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 2. Washington, DC: American Psychiatric Association; 1968.

    Google Scholar 

  5. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 3. Washington, DC: American Psychiatric Association; 1980.

    Google Scholar 

  6. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 3 (revised). Washington, DC: American Psychiatric Association; 1987.

    Google Scholar 

  7. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  8. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4 (text revision). Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  9. Kraemer HC: DSM categories and dimensions in clinical and research contexts. Int J Methods Psychiatr Res 2007, 16(Suppl 1):S8–S15.

    Article  PubMed  Google Scholar 

  10. Flaum M, Amador X, Gorman JM, et al.: DSM-IV field trial for schizophrenia and other psychotic disorders. In DSM-IV Sourcebook. Edited by Widiger TA, Frances AJ, Pincus HA, et al. Washington, DC: American Psychiatric Association; 1994:687–713.

    Google Scholar 

  11. Nurnberger JI Jr, Blehar MC, Kaufmann CA, et al.: Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatry 1994, 51:849–859; discussion 863–864.

    PubMed  Google Scholar 

  12. Maj M, Pirozzi R, Formicola AM, et al.: Reliability and validity of the DSM-IV diagnostic category of schizoaffective disorder: preliminary data. J Affect Disord 2000, 57:95–98.

    Article  PubMed  CAS  Google Scholar 

  13. Schwartz JE, Fennig S, Tanenberg-Karant M, et al.: Congruence of diagnoses 2 years after a first-admission diagnosis of psychosis. Arch Gen Psychiatry 2000, 57:593–600.

    Article  PubMed  CAS  Google Scholar 

  14. Salvatore P, Baldessarini RJ, Tohen M, et al.: McLean-Harvard International First-Episode Project: two-year stability of DSM-IV diagnoses in 500 first-episode psychotic disorder patients. J Clin Psychiatry 2009, 70:458–466.

    Article  PubMed  Google Scholar 

  15. Vollmer-Larsen A, Jacobsen TB, Hemmingsen R, Parnas J: Schizoaffective disorder—the reliability of its clinical diagnostic use. Acta Psychiatr Scand 2006, 113:402–407.

    Article  PubMed  CAS  Google Scholar 

  16. Abrams DJ, Rojas DC, Arciniegas DB: Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature. Neuropsychiatr Dis Treat 2008, 4:1089–1109.

    PubMed  Google Scholar 

  17. Cheniaux E, Landeira-Fernandez J, Lessa Telles L, et al.: Does schizoaffective disorder really exist? A systematic review of the studies that compared schizoaffective disorder with schizophrenia or mood disorders. J Affect Disord 2008, 106:209–217.

    Article  PubMed  Google Scholar 

  18. Malhi GS, Green M, Fagiolini A, et al.: Schizoaffective disorder: diagnostic issues and future recommendations. Bipolar Disord 2008, 10:215–230.

    Article  PubMed  Google Scholar 

  19. Potash JB: Carving chaos: genetics and the classification of mood and psychotic syndromes. Harv Rev Psychiatry 2006, 14:47–63.

    Article  PubMed  Google Scholar 

  20. Harrow M, Grossman LS, Herbener ES, Davies EW: Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry 2000, 177:421–426.

    Article  PubMed  CAS  Google Scholar 

  21. Strakowski SM, Keck PE Jr, Sax KW, et al.: Twelve-month outcome of patients with DSM-III-R schizoaffective disorder: comparisons to matched patients with bipolar disorder. Schizophr Res 1999, 35:167–174.

    Article  PubMed  CAS  Google Scholar 

  22. Jager M, Bottlender R, Strauss A, Moller HJ: Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand 2004, 109:30–37.

    Article  PubMed  CAS  Google Scholar 

  23. Leonhard K: Aufteilung der Endogenen Psychosen. Berlin: Akademie Verlag; 1957.

    Google Scholar 

  24. Laursen TM, Labouriau R, Licht RW, et al.: Family history of psychiatric illness as a risk factor for schizoaffective disorder: a Danish register-based cohort study. Arch Gen Psychiatry 2005, 62:841–848.

    Article  PubMed  Google Scholar 

  25. Hamshere ML, Bennett P, Williams N, et al.: Genomewide linkage scan in schizoaffective disorder: significant evidence for linkage at 1q42 close to DISC1, and suggestive evidence at 22q11 and 19p13. Arch Gen Psychiatry 2005, 62:1081–1088.

    Article  PubMed  CAS  Google Scholar 

  26. Murray RM, Sham P, Van Os J, et al.: A developmental model for similarities and dissimilarities between schizophrenia and bipolar disorder. Schizophr Res 2004, 71:405–416.

    Article  PubMed  Google Scholar 

  27. Benes FM, Berretta S: GABAergic interneurons: implications for understanding schizophrenia and bipolar disorder. Neuropsychopharmacology 2001, 25:1–27.

    Article  PubMed  CAS  Google Scholar 

  28. Hill SK, Harris MS, Herbener ES, et al.: Neurocognitive allied phenotypes for schizophrenia and bipolar disorder. Schizophr Bull 2008, 34:743–759.

    Article  PubMed  Google Scholar 

  29. Kraepelin E: Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. Achte, Vollständig Umgearbeitete Auflage. 3. Band. Klinische Psychiatrie. 2. Teil. Leipzig, Germany: Verlag Von Johann Ambrosius Barth; 1913.

    Google Scholar 

  30. Kraepelin E: Die erscheinungsformen des irreseins. Z Gesamte Neurol Psychiatr 1920, 62:1–29.

    Article  Google Scholar 

  31. Carpenter WT Jr, Buchanan RW, Kirkpatrick B, et al.: Strong inference, theory testing, and the neuroanatomy of schizophrenia. Arch Gen Psychiatry 1993, 50:825–831.

    PubMed  Google Scholar 

  32. Kendler KS, Karkowski LM, Walsh D: The structure of psychosis: latent class analysis of probands from the Roscommon Family Study. Arch Gen Psychiatry 1998, 55:492–499.

    Article  PubMed  CAS  Google Scholar 

  33. Fink M, Taylor MA: The medical evidence-based model for psychiatric syndromes: return to a classical paradigm. Acta Psychiatr Scand 2008, 117:81–84.

    PubMed  Google Scholar 

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  1. Vanderbilt University Psychiatric Hospital, 1601 23rd Avenue South, Room 3060, Nashville, TN, 37212, USA

    Stephan Heckers

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  1. Stephan Heckers
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Correspondence to Stephan Heckers.

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Heckers, S. Is schizoaffective disorder a useful diagnosis?. Curr Psychiatry Rep 11, 332–337 (2009). https://doi.org/10.1007/s11920-009-0048-3

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  • DOI: https://doi.org/10.1007/s11920-009-0048-3

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