Course of Schizoaffective Psychoses: Results of a Followup Study

Abstract

The course of illness was investigated retrospectively and prospectively in a sample of 150 hospitalized schizoaffective patients and 95 hospitalized bipolar manic-depressive patients. The two disorders showed more similarities than differences in their course; this was true for the age of onset (31.8 versus 34.7 years) and the length of illness until the end of the observation period (22.5 versus 23.8 years). Schizoaffective disorders took a more benign course than bipolar disorders, as measured by the frequency of the episodes (median 7 versus 9 episodes). Accordingly, periods of remission between episodes were longer in schizoaffective patients. The length of the episodes themselves was about the same in both disorders (median 3 months). Although subjects had reached an average age of 60 years, 63% of schizoaffective and 82% of bipolar patients had experienced new episodes during the last 5 years of the observation period. Patients with schizoaffective psychoses were less likely to achieve a full remission than patients with bipolar disorders. A residual state was observed in 57% of schizoaffective and 24% of bipolar patients during the intervals between episodes. Because both schizoaffective and bipolar disorders showed a highly recurrent course, many patients received long-term treatment with neuroleptic drugs, antidepressants, or lithium.

Stability of Schizoaffective Disorder in Correlation with Duration of Follow-Up: Retrospective Analysis

“…This finding is in accordance with data regarding the affective nature of SAD episodes, e.g. Angst et al [14] found that 64% of the patients had manic or mixed manic and depressive symptomatology. In our study, only 17% of the patients had pure depressive episodes.…”

“…Angst et al [14] found that SAD and bipolar disorder had more similarities than differences in their course, and that SAD had a somewhat more benign course than bipolar disorder, while others showed that SAD has a worse course and outcome than bipolar disorder [5,9] . Findings regarding the impact of SAD subtype on the course and prognosis are inconsistent as well, e.g.…”

Public health significance of bipolar disorder: implications for early intervention and prevention

“…This appears to have face validity in terms of patients reporting ‘self‐medication’ of depressive or manic symptoms by illicit substances. Third, higher numbers of manic and depressive episodes are associated with a shortening of the cycle and increased rate of relapse . Fourth, untreated illness may interfere with the attainment of age‐specific social, psychological, and educational developmental goals.…”

Schizoaffective States: Understandability and Outcome

“…The problem with the concept of 'schizoaffective' as a solution to the problem of demarcation between schizophrenia and affective psychosis is the heterogenousnature of the syndromeevenwhenoperationally defined. Follow-up studies indicate that while, as a group, the prognosisof schizoaffectives liessomewhere between schizophrenia and affective disorders, there is considerable variability in outcome, with some subgroups resembling schizophrenia and others closer to affectivedisorder (Tsuang & Dempsey, 1979;Angst et al, 1980;Brockington et al, 1980a, b;Pope et al, 1980;Grossman et al, 1984;Maj, 1985;Levinson & Levitt, 1987;Williams & McGlashen, 1987). Schneider's (1959), approach to the problem of demarcation was to suggest that there were certain first rank symptoms (FRS) which were pathognomonic for schizophrenia.…”