What we know and what we don't know about the treatment of schizoaffective disorder (original) (raw)
Related papers
Acta Psychiatrica Scandinavica, 2010
Objective: Schizoaffective disorder is a common diagnosis in mental health services. The aim of the present article was to review treatment studies for schizoaffective disorder and draw conclusions for clinical decision making.Method: We searched MEDLINE and Cochrane Library for relevant clinical trials and review articles up to the year 2008.Results: Thirty-three studies using standardized diagnostic criteria, 14 of which were randomized controlled trials, could be identified. The comparability of studies is limited by the use of different diagnostic criteria. The studies reviewed do not permit consistent recommendations as to whether schizoaffective disorder should be treated primarily with antipsychotics, mood stabilizers or combinations of these drugs. The relevance of diverse subtypes of schizoaffective disorder for treatment recommendations is unclear.Conclusion: The pertinent empirical database is small and heterogeneous. The lack of conclusive recommendations is related to issues of nosological status, plurality of diagnostic criteria and validity of the concept of schizoaffective disorder.
Treatment of Schizoaffective Disorders
Schizophrenia Bulletin, 1984
Studies that compare the treatment response of patients diagnosed as primary affective disorder or schizoaffective disorder are reviewed.
Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature
Neuropsychiatric disease and treatment, 2008
Considerable debate surrounds the inclusion of schizoaffective disorder in psychiatric nosology. Schizoaffective disorder may be a variant of schizophrenia in which mood symptoms are unusually prominent but not unusual in type. This condition may instead refl ect a severe form of either major depressive or bipolar disorder in which episode-related psychotic symptoms fail to remit completely between mood episodes. Alternatively, schizoaffective disorder may refl ect the co-occurrence of two relatively common psychiatric illnesses, schizophrenia and a mood disorder (major depressive or bipolar disorder). Each of these formulations of schizoaffective disorder presents nosological challenges because the signs and symptoms of this condition cross conventional categorical diagnostic boundaries between psychotic disorders and mood disorders. The study, evaluation, and treatment of persons presently diagnosed with schizoaffective may be more usefully informed by a dimensional approach. It is in this context that this article reviews and contrasts the categorical and dimensional approaches to its description, neurobiology, and treatment. Based on this review, an argument for the study and treatment of this condition using a dimensional approach is offered.
Schizoaffective disorder final published
Schizoaffective disorder as a diagnostic entity is of particular present-day relevance; however, the concept of schizoaffective disorder, and its management and prognosis remain contentious. Descriptions of the disorder have varied over time. In this literature review, after tracking the evolution of the concept and nosology of schizoaffective disorder, research findings are summarized. This review takes a broad overview of the epidemiology, neurobiology, clinical presentation, diagnostic validity and stability, treatment, course, and outcome of schizoaffective disorder. Importance is given to the distinctness of schizoaffective disorder, and the overlap with schizophrenia and mood disorders, and problems associated with the construct are examined. Possible ways to treat the construct in the future¾in the best interest of patients, clinicians, and researchers¾are discussed.
Combination therapy or monotherapy for the depressed type of schizoaffective disorder
Neuropsychiatric Disease and Treatment, 2009
Several studies have demonstrated the effectiveness of adjunctive antidepressant drug therapy to improve the depressive or negative symptoms of schizoaffective disorder, however, monotherapy with atypical antipsychotics may be advantageous. We compared the efficacy and safety of risperidone monotherapy versus combination therapy of haloperidol with sertaline for the acute treatment of schizoaffective disorder, depressed type. This is an open label study of 52 female inpatients randomly assigned to risperidone alone (N = 26) or haloperidol in combination with sertraline (N = 26) for 12 weeks. The mean daily doses of medications were: risperidone: 3.75-3.29 mg/day, haloperidol: 5.35-4.15 mg/day, sertraline: 65.39-133.82 mg/day. Efficacy was measured using clinical rating scales of treatment, safety, and tolerability. Risperidone patients showed statistically significant greater improvement than haloperidol-sertraline patients on efficacy measures including Positive and Negative Syndro...
[Schizoaffective Disorder: Evolution and Current Status of the Concept]
Türk psikiyatri dergisi = Turkish journal of psychiatry, 2015
Schizoaffective disorder as a diagnostic entity is of particular present-day relevance; however, the concept of schizoaffective disorder, and its management and prognosis remain contentious. Descriptions of the disorder have varied over time. In this literature review, after tracking the evolution of the concept and nosology of schizoaffective disorder, research findings are summarized. This review takes a broad overview of the epidemiology, neurobiology, clinical presentation, diagnostic validity and stability, treatment, course, and outcome of schizoaffective disorder. Importance is given to the distinctness of schizoaffective disorder, and the overlap with schizophrenia and mood disorders, and problems associated with the construct are examined. Possible ways to treat the construct in the future in the best interest of patients, clinicians, and researchers are discussed.
Schizoaffective disorder : consistency of diagnosis
Indian journal of psychiatry, 1999
Seventy six, first episode, drug naive patients of schizoaffective disorder, diagnosed as per DSM-III-R criteria, were followed up over a period of two years in order to verify the consistency of diagnosis. It was observed that only in 14 (18.4%) patients diagnosis did not change over a period of two years. In the majority of the patients (47, 61.9%) the diagnosis changed to schizophrenia. Eight patients (10.5%) had only depressive symptoms during the subsequent episodes and they satisfied the diagnostic criteria for major depression. While 7 (9.2%) patients remained symptom free over the study period and so diagnosis of schizoaffecive disorder could not bejeconfirmed. The paper cautions against the diagnosis of schizoaffective disorder early in course of illness.
Schizoaffective Disorder: Evolution and Current Status of the Concept 2
2013
SUMMARY Schizoaffective disorder as a diagnostic entity is of particular present-day relevance; however, the concept of schizoaffective disorder, and its management and prognosis remain contentious. Descriptions of the disorder have varied over time. In this literature review, after tracking the evolution of the concept and nosology of schizoaffective disorder, research findings are summarized. This review takes a broad overview of the epidemiology, neurobiology, clinical presentation, diagnostic validity and stability, treatment, course, and outcome of schizoaffective disorder. Importance is given to the distinctness of schizoaffective disorder, and the overlap with schizophrenia and mood disorders, and problems associated with the construct are examined. Possible ways to treat the construct in the future¾in the best interest of patients, clinicians, and researchers¾are discussed.
Is Schizoaffective Disorder a Stable Diagnostic Category: A Retrospective Examination
Psychiatric Quarterly, 2000
Debate continues about whether clear nosologic boundaries can be drawn between schizoaffective disorder (SA), schizophrenia (SP), and bipolar disorder (BPD). This study attempted to clarify these boundaries. A retrospective review of the records of adult psychiatric inpatients with DSM-IV diagnoses of SA (n = 96), SP (n = 245), and BPD (n = 203) was conducted. Patients were assessed at admission and discharge using standardized rating scales (completed by physicians and nurses) and self-report inventories. Differential improvement over time also was examined. Significant differences were found for gender, legal status at admission, age, LOS, episode number, and ethnicity. Overall, SA was rated by clinicians as intermediate between SP and BPD, although SA rated themselves as the most severe. SA was similar to SP on positive symptoms, intermediate on negative symptoms, and similar to BPD on moodand distress-related symptoms. Independent of diagnosis, differences in change scores from admission to discharge were related to severity level at admission.