Differences between first episode schizophrenia and schizoaffective disorder

Cotton, S. M.; Lambert, M.; Schimmelmann, B. G.; Mackinnon, A.; Gleeson, J. F. M.; Berk, M.; Hides, L.; Chanen, A. M.; Scott, J; Schöttle, D.; McGorry, P. D.; Conus, P. (2013). Differences between first episode schizophrenia and schizoaffective disorder. Schizophrenia Research, 147(1), pp. 169-174. Elsevier 10.1016/j.schres.2013.02.036

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Background

The diagnostic and clinical overlap between schizophrenia and schizoaffective disorder is an important nosological issue in psychiatry that is yet to be resolved. The aim of this study was to compare the clinical and functional characteristics of an epidemiological treated cohort of first episode patients with an 18-month discharge diagnosis of schizophrenia (FES) or schizoaffective disorder (FESA).

Methods

This study was part of the larger First Episode Psychosis Outcome Study (FEPOS) which involved a medical file audit study of all 786 patients treated at the Early Psychosis Prevention and Intervention Centre between 1998 and 2000. Of this cohort, 283 patients had an 18-month discharge diagnosis of FES and 64 had a diagnosis of FESA. DSM-IV diagnoses and clinical and functional ratings were derived and validated by two consultant psychiatrists.

Results

Compared to FES patients, those with FESA were significantly more likely to have a later age of onset (p=.004), longer prodrome (p=.020), and a longer duration of untreated psychosis (p<.001). At service entry, FESA patients presented with a higher illness severity (p=.020), largely due to the presence of more severe manic symptoms (p<.001). FESA patients also had a greater number of subsequent inpatient admissions (p=.017), had more severe depressive symptoms (p=.011), and higher levels of functioning at discharge.

Discussion

The findings support the notion that these might be considered two discernable disorders; however, further research is required to ascertain the ways and extent to which these disorders are discriminable at presentation and over time.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy 04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy > Research Division
UniBE Contributor:	Schimmelmann, Benno Karl Edgar
Subjects:	100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health
ISSN:	0920-9964
Publisher:	Elsevier
Language:	English
Submitter:	Myriam Pyrlik
Date Deposited:	04 Oct 2013 14:36
Last Modified:	05 Dec 2022 14:11
Publisher DOI:	10.1016/j.schres.2013.02.036
PubMed ID:	23528796
Web of Science ID:	000308580100196
URI:	https://boris.unibe.ch/id/eprint/14630 (FactScience: 221703)