• We examined thought disorder in 22 patients with schizoaffective disorder (12 schizoaffective-manic and ten schizoaffective-depressed) using Research Diagnostic Criteria. The Thought Disorder Index was used to tag 22 categories of thought disorder that ranged from mild to severe. Qualitative patterns in the thought disorder of schizoaffective patients were compared with those of 20 manic and 43 schizophrenic patients. Manic and schizoaffective-manic patients produced a high number of combinatory responses, but those produced by the schizoaffective-manic patients lacked the humor and playfulness of those of the manics. The schizoaffective-manic patients, like the schizophrenic patients, produced a high number of responses in the categories of idiosyncratic verbalizations, autistic thinking, and confusion. Unlike the manic patients, schizoaffective-depressed patients generally produced a few absurd and idiosyncratic responses in a setting of constricted output. The data strongly suggest that the thinking disorders of schizoaffective patients are like those of the schizophrenic patients.

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=psych&articleId=493945&pdfFileName=archpsyc_44_1_004.pdf

Comparative studies of thought disorders. II. Schizoaffective disorder.

A study of 32 patients meeting criteria for 'schizomanic' psychosis is described. These psychoses account for about 1% of hospital admissions. Very few first-degree relatives had either schizophrenia or mania. Lithium seemed an effective treatment. Twenty-four patients made a full recovery, and the series as a whole was closer to manic depressive psychosis than schizophrenia on all outcome measures. Some diagnosis clues are suggested to help the clinician to recognize the patients with a poor prognosis. These findings are in line with other studies, and suggest that most of these patients should be regarded as manic. This conclusion should lead to some revision of present ideas on the incidence and diagnosis of mania.

Manic patients with schizophrenic or paranoid symptoms.

The evidence indicating that the forms of schizophrenia in men and women represent different morbid states is reviewed. Age of onset and gender are considered to be of fundamental importance in determining the different symptomatological and evolutionary features of the syndrome in the two sexes. Early-onset forms in males are associated with chronicity, absence of familial predisposition for psychosis, and the presence of structural cerebral pathology specifically involving the dominant hemisphere. Later onset forms in females are characterized by more florid symptoms, more affective features, more familial psychosis, and more favorable outcome with no or less pronounced structural cerebral involvement. It is argued that these differential characteristics derive from the differential hemispheric organization of the male and female brain--which also determines the male susceptibility to other psychopathological syndromes such as psychopathy and sexual deviations as well as the excess in women of schizoaffective states, affective disorders, and late-onset schizophrenia.

/pdf/influence-of-gender-in-schizophrenia-as-related-to-other-5abgo5j9mk.pdf

Influence of Gender in Schizophrenia as Related to Other Psychopathological Syndromes

• Schizoaffective disorder, traditionally classified under schizophrenia, recently tends to be subsumed under affective disorder. This article reports a study of 35 sib pairs, where each six was independently diagnosed as having schizophrenia (SC), affective disorder (AD), or schizoaffective disorder (SA). The observed numbers of same-diagnosis pairs (ADAD, SASA, SCSC) were compared with the numbers expected if the three disorders are genetically independent. The results showed a significant deficiency only in the observed number of SASA pairs, which suggests that schizophrenia and affective disorder are genetically distinct whereas schizoaffective disorder is not. To test whether schizoaffective disorder is a variant of affective disorder or schizophrenia, the observed number of ADSA and SASC pairs were compared against the expected numbers. No significant differences were found, which suggests that schizoaffective disorder is genetically heterogeneous, with at least two subtypes, one a variant of affective disorder, the other a variant of schizophrenia.

'Schizoaffective Disorder': Dead or Alive?

A review of a number of major studies of the outcome of schizoaffective disorders, focusing on how schizoaffective disorders should be viewed diagnostically, is presented. An analysis is made of various research methods used, including prospective, retrospective, and prognostic approaches. Results of the analysis suggest that prospective studies are more valuable. The research results on outcome question the thesis that schizoaffective disorders are only affective disorders. Overall, the mixed results reveal that the outcome of schizoaffecti ve disorders is poorer than that of affective disorders and better than that of schizophrenia . Since outcome is one type of validating criterion which can be used for establishing diagnostic categories, the results question aspects of the DSM-IH system of categorizing schizoaffective disorders. We suggest that moodincongruent psychotic symptoms either influence outcome negatively or are associated with other features which influence outcome negatively.

/pdf/outcome-in-schizoaffective-disorders-a-critical-review-and-jm71f12azn.pdf

Outcome in Schizoaffective Disorders: A Critical Review and Reevaluation of the Literature

Bipolar course in schizo-affective illness.

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Bipolar course in schizo-affective illness.