How reasonable is it to uphold the diagnostic concept of schizoaffective disorder?

Baethge, Christopher

doi:10.1111/bdi.12920

Cited by 4 publications

(3 citation statements)

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“…Pedersen (2009) L. Tondo, G.H. Vázquez, C. Baethge зі співавторами (2016), C. Baethge (2020)) ставити під сумнів категоріальний підхід, який було використано в системах класифікації DSM-IV та МКХ-10 [19]. Також, відсутність у МКХ-10 діагностичних критеріїв, які виключають афективні розлади при діагностиці шизофренії, пояснює більш високу частоту встановлення даного діагнозу, ніж при використанні DSM-IV.…”

Section: резюмеunclassified

Modern Scientific Views on the Clinic, Systematics, Diagnosis and Pathopersonalogy of Endogenous Psychosis With Episodic Course (Literature Riview)

Підлубний

Хоміцький

2020

UJMH

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The aim of the study. To study the literature in order to identify modern scientific views on the clinic, systematics, diagnosis and pathopersonalogy of endogenous psychoses with episodic course. Results. The analysis of the literature shows that the diagnostic and classification approaches of endogenous psychoses with episodic course, are focused on polymorphic and variable symptoms of exacerbation of the disease. This leads to diagnostic mistakes, errors in the appointment of maintenance therapy, deterioration of compliance and further deepening of social maladaptation of patients. Refusal to develop the mechanisms of pathogenesis on the basis of the nosological approach will inevitably lead to a regression of the level of treatment and rehabilitation approaches - from ethiopathogenetic to symptomatic. Conclusions. Thus, at present, the importance of diagnostic techniques aimed at assessing and differentiating persistent symptoms of the disease in the period of remission of endogenous psychoses and relate to pathopersonalogical transformations. Research and correct diagnostic assessment of this multicomponent cluster of psychopathological symptoms allows to assess the nosological affiliation of a particular clinical case and to determine the necessary pharmacological and social rehabilitation effects in order to correct existing pathopersonalogical transformations and prevent exacerbation of endogenous psychosis.

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Section: резюмеunclassified

Modern Scientific Views on the Clinic, Systematics, Diagnosis and Pathopersonalogy of Endogenous Psychosis With Episodic Course (Literature Riview)

Підлубний

Хоміцький

2020

UJMH

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“…However, it remains unclear whether sleep spindle deficiency is a specific marker for schizophrenia or whether it also occurs more broadly in people with schizophrenia spectrum disorder such as schizoaffective disorders. Although existence of schizoaffective disorders as real and operative diagnostic entity remains controversial [ 28 – 30 ], their diagnosis corresponds to patients who display a mixture of psychotic features related to schizophrenia and of mood symptoms related to bipolar disorders. Therefore, this diagnosis can include a diversity of symptoms fluctuating between schizophrenia (SZ) and mood disorders.…”

Section: Introductionmentioning

confidence: 99%

Sleep spindles in people with schizophrenia, schizoaffective disorders or bipolar disorders: a pilot study in a general population-based cohort

et al. 2022

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Background Sleep spindles have been involved in sleep stabilization and sleep-related memory mechanisms and their deficit emerged as possible biomarker in schizophrenia. However, whether this sleep phenotype is also present in other disorders that share psychotic symptoms remains unclear. To address this gap, we assessed sleep spindles in participants of a prospective population-based cohort who underwent psychiatric assessment (CoLaus|PsyCoLaus) and polysomnographic recording (HypnoLaus). Methods Sleep was recorded using ambulatory polysomnography in participants (N = 1037) to the PsyCoLaus study. Sleep spindle parameters were measured in people with a lifelong diagnosis of schizophrenia (SZ), schizoaffective depressive (SAD), schizoaffective manic (SAM), bipolar disorder type I (BP-I) and type II (BP-II). The associations between lifetime diagnostic status (independent variables, SZ, SAD, SAM, BPD-I, BPD-II, controls) and spindle parameters (dependent variables) including density, duration, frequency and maximum amplitude, for all (slow and fast), slow- and fast-spindle were assessed using linear mixed models. Pairwise comparisons of the different spindle parameters between the SZ group and each of the other psychiatric groups was performed using a contrast testing framework from our multiple linear mixed models. Results Our results showed a deficit in the density and duration of sleep spindles in people with SZ. They also indicated that participants with a diagnosis of SAD, SAM, BP-I and BP-II exhibited different sleep spindle phenotypes. Interestingly, spindle densities and frequencies were different in people with a history of manic symptoms (SAM, BP-I, and BP-II) from those without (SZ, SAD). Conclusions Although carried out on a very small number of participants due to the low prevalence of these disorders in general population, this pilot study brought new elements that argued in favor of a deficit of sleep spindles density and duration in people with schizophrenia. In addition, while we could expect a gradual change in intensity of the same sleep spindle parameters through psychotic diagnoses, our results seem to indicate a more complex situation in which the frequency of sleep spindles might be more impacted by diagnoses including a history of mania or hypomania. Further studies with a larger number of participants are required to confirm these effects.

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“…However, it has been shown that SAD has a better course and prognosis than schizophrenia but a worse outcome compared with bipolar disorder (Malaspina et al, 2013). Another measure of validity for psychiatric diagnoses is temporal stability (Baethge, 2020). In the meta-analysis in which Santelmann et al investigated the diagnostic switch in patients with SAD, 36% of patients with a SAD diagnosis had a switch in their second reassessment after an average of 2 years, with 19% being diagnosed with schizophrenia and 14% being diagnosed with an affective disorder (Santelmann et al, 2016).…”

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confidence: 99%

The Course Patterns and Diagnostic Shifts of Patients With Schizoaffective Disorder

Yıldırım¹,

Aydin

Uğur

2023

J Nerv Ment Dis

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Since its introduction, schizoaffective disorder (SAD) has been one of the most controversial diagnoses in psychiatry, both clinically and nosologically. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), SAD diagnostic criteria were changed, and instead of a cross-sectional diagnosis, a longitudinal approach covering the life course of the illness was adopted. In this study, the meaning of this conceptual shift in the diagnosis of SAD in clinical practice is investigated throughout the course of the illness for patients with SAD. Sixty-two inpatients diagnosed with SAD according to DSM-5 diagnostic criteria are included in this study. The course of the illness from its onset to the present is investigated retrospectively. The disease duration is 18.3 ± 9.1 years. The most common diagnoses in the first hospitalization are bipolar disorder (manic episodes) and psychotic disorder, not otherwise specified. Furthermore, the time that elapsed between the first psychiatric application of the patients and the diagnosis of SAD is 9.5 ± 7.3 years. Further, when the course of the illness is grouped according to the predominance of affective and psychotic disorders, recurrent affective disorders are observed most frequently (29.3%), followed by mixed-episode disorders and a shift from affective disorders to psychotic disorders (22.4%). It is found that SAD has a heterogeneous course, and affective disorder diagnoses are more dominant during the course of the illness. The clinical relevance of the longitudinal emphasis on the total duration of the illness in the DSM-5 is also demonstrated. The affective and psychotic dichotomy, based on Kraepelin, has failed to elucidate the course of the disease in clinical practice. Therefore, clinicians should meticulously evaluate the entire course of the illness for SAD and avoid conclusive judgments over a single episode.

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How reasonable is it to uphold the diagnostic concept of schizoaffective disorder?

Cited by 4 publications

References 5 publications

Modern Scientific Views on the Clinic, Systematics, Diagnosis and Pathopersonalogy of Endogenous Psychosis With Episodic Course (Literature Riview)

Modern Scientific Views on the Clinic, Systematics, Diagnosis and Pathopersonalogy of Endogenous Psychosis With Episodic Course (Literature Riview)

Sleep spindles in people with schizophrenia, schizoaffective disorders or bipolar disorders: a pilot study in a general population-based cohort

The Course Patterns and Diagnostic Shifts of Patients With Schizoaffective Disorder

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