Characteristics of patients diagnosed with schizoaffective disorder compared with schizophrenia and bipolar disorder

被引:50
作者
Pagel, Tobias [1 ]
Baldessarini, Ross J. [2 ,3 ]
Franklin, Jeremy [4 ]
Baethge, Christopher [1 ,3 ]
机构
[1] Univ Cologne, Sch Med, Dept Psychiat & Psychotherapy, D-50937 Cologne, Germany
[2] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[3] Massachusetts Gen Hosp, Int Consortium Psychot & Bipolar Disorders Res, McLean Div, Boston, MA 02114 USA
[4] Univ Cologne, Sch Med, Inst Med Stat Informat & Epidemiol, D-50937 Cologne, Germany
关键词
bipolar; meta-analysis; schizoaffective; schizophrenia; PSYCHOTIC MOOD DISORDERS; TERM-FOLLOW-UP; PSYCHIATRIC-DISORDERS; CLINICAL-FEATURES; NEGATIVE SYMPTOMS; THOUGHT-DISORDER; RISK-FACTOR; PREVALENCE; POPULATION; CLOZAPINE;
D O I
10.1111/bdi.12057
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives Information on basic demographic and clinical characteristics of schizoaffective disorder is sparse and subject to sampling bias and low diagnostic reliability. In the present study we aimed to: (i) estimate the demographic and clinical descriptors in schizoaffective disorder patients and (ii) compare the findings with those with schizophrenia and bipolar disorder. Methods To minimize sampling bias and low reliability, we systematically reviewed studies that simultaneously compared schizoaffective, schizophrenia, and bipolar disorder patients. We estimated demographic, clinical, and psychometric characteristics based on weighted pooling, and compared disorders by meta-analysis. We also estimated whether schizoaffective disorder is closer to schizophrenia or to bipolar disorder. Results We identified 50 studies that included 18312 patients. Most characteristics of the 2684 schizoaffective disorder patients fell between those of 4814 diagnosed with bipolar disorder and 10814 with schizophrenia. However, the schizoaffective group had the highest proportion of women (52%), had the youngest age at illness onset (23.3 +/- 3.8years), and had the highest standardized ratings of psychosis and depression. Differences in pooled parameters between schizoaffective versus schizophrenia and versus bipolar disorder subjects were similar. Values for patients with schizoaffective disorders mostly were intermediate between schizophrenia and bipolar disorder. However, the majority of studies showed schizoaffective patients to be more like schizophrenia than bipolar disorder patients in seven out of nine demographic and clinical categories as well as in five out of eight psychometric measures. These results remained similar when we restricted the analyses to studies with psychotic bipolar disorder patients only or to studies using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IIIR and DSM-IV only. Conclusions The present study provided estimates of important characteristics of schizoaffective disorder as balanced as possible in summarizing the findings from observational studies as unbiased as possible. The results did not support the hypothesis that schizoaffective disorder is primarily an affective disorder. The stronger resemblance of schizoaffective disorder to schizophrenia than to bipolar disorder needs further investigation.
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收藏
页码:229 / 239
页数:11
相关论文
共 79 条
[1]  
AMADOR XF, 1994, ARCH GEN PSYCHIAT, V51, P826
[2]  
Angst J, 1995, Schweiz Arch Neurol Psychiatr (1985), V146, P17
[3]  
[Anonymous], 1994, INT CLASS DIS
[4]  
[Anonymous], 2000, DIAGN STAT MAN MENT, DOI DOI 10.1176/APPI.BOOKS.9780890425787
[5]   Differences in the prevalence of psychosensory features among schizophrenic, schizoaffective, and manic patients [J].
AtreVaidya, N ;
Taylor, MA .
COMPREHENSIVE PSYCHIATRY, 1997, 38 (02) :88-92
[6]   Is schizoaffective disorder a stable diagnostic category: A retrospective examination [J].
Averill, PM ;
Reas, DL ;
Shack, A ;
Shah, NN ;
Cowan, K ;
Krajewski, K ;
Kopecky, C ;
Guynn, RW .
PSYCHIATRIC QUARTERLY, 2004, 75 (03) :215-227
[7]   Hallucinations in bipolar disorder: characteristics and comparison to unipolar depression and schizophrenia [J].
Baethge, C ;
Baldessarini, RJ ;
Freudenthal, K ;
Streeruwitz, A ;
Bauer, M ;
Bschor, T .
BIPOLAR DISORDERS, 2005, 7 (02) :136-145
[8]   Prophylaxis of schizoaffective disorder with lithium or carbamazepine:: outcome after long-term follow-up [J].
Baethge, C ;
Gruschka, P ;
Berghöfer, A ;
Bauer, M ;
Müller-Oerlinghausen, B ;
Bschor, T ;
Smolka, MN .
JOURNAL OF AFFECTIVE DISORDERS, 2004, 79 (1-3) :43-50
[9]   Long-term treatment of schizoaffective disorder: Review and recommendations [J].
Baethge, C .
PHARMACOPSYCHIATRY, 2003, 36 (02) :45-56
[10]  
BANOV MD, 1994, J CLIN PSYCHIAT, V55, P295