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PLoS One. 2013 May 30;8(5):e63734. doi: 10.1371/journal.pone.0063734. Print 2013.

Empirical support for DSM-IV schizoaffective disorder: clinical and cognitive validators from a large patient sample.

Author information

1
Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, New York, USA. pderosse@lij.edu

Abstract

OBJECTIVE:

The diagnosis of schizoaffective disorder has long maintained an uncertain status in psychiatric nosology. Studies comparing clinical and biological features of patients with schizoaffective disorder to patients with related disorders [e.g., schizophrenia and bipolar disorder] can provide an evidence base for judging the validity of the diagnostic category. However, because most prior studies of schizoaffective disorder have only evaluated differences between groups at a static timepoint, it is unclear how these disorders may be related when the entire illness course is taken into consideration.

METHODS:

We ascertained a large cohort [N = 993] of psychiatric patients with a range of psychotic diagnoses including schizophrenia with no history of major affective episodes [SZ-; N = 371], schizophrenia with a superimposed mood syndrome [SZ+; N = 224], schizoaffective disorder [SAD; N = 129] and bipolar I disorder with psychotic features [BPD+; N = 269]. Using cross-sectional data we designed key clinical and neurocognitive dependent measures that allowed us to test longitudinal hypotheses about the differences between these diagnostic entities.

RESULTS:

Large differences between diagnostic groups on several demographic and clinical variables were observed. Most notably, groups differed on a putative measure of cognitive decline. Specifically, the SAD group demonstrated significantly greater post-onset cognitive decline compared to the BP+ group, with the SZ- and SZ+ group both exhibiting levels of decline intermediate to BPD+ and SAD.

CONCLUSIONS:

These results suggest that schizoaffective disorder may possess distinct features. Contrary to earlier formulations, schizoaffective disorder may be a more severe form of illness.

PMID:
23737946
PMCID:
PMC3667842
DOI:
10.1371/journal.pone.0063734
[Indexed for MEDLINE]
Free PMC Article
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