Differences between first episode schizophrenia and schizoaffective disorder

SCHIZOPHRENIA RESEARCH

卷:147

Article

Cotton, S. M.^1,2  Lambert, M.³  Schimmelmann, B. G.⁴  Mackinnon, A.^1,2  Gleeson, J. F. M.⁵  Berk, M.^1,2,6,7  Hides, L.⁸  Chanen, A. M.^1,2  Scott, J.⁹  Schoettle, D.³  McGorry, P. D.^1,2  Conus, P.¹⁰ 

[1] Orygen Youth Hlth Res Ctr, Melbourne, Vic, Australia

[2] Univ Melbourne, Ctr Youth Mental Hlth, Parkville, Vic 3052, Australia

[3] Univ Med Ctr Hamburg Eppendorf, PEDIC, Dept Psychiat & Psychotherapy, Ctr Psychosocial Med, Hamburg, Germany

[4] Univ Bern, Univ Hosp Child & Adolescent Psychiat, CH-3012 Bern, Switzerland

[5] Australian Catholic Univ, Sch Psychol, Sydney, NSW 2059, Australia

[6] Deakin Univ, Geelong, Vic 3217, Australia

[7] Florey Inst Neurosci & Mental Hlth, Parkville, Vic, Australia

[8] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld 4001, Australia

[9] Univ Queensland, Clin Res Ctr, Brisbane, Qld, Australia

[10] Univ Lausanne, Treatment & Early Intervent Psychosis Program TIP, Dept Psychiat CHUV, Clin Cery, CH-1008 Prilly, Switzerland

关键词: Schizophrenia;    Schizoaffective disorder;    First episode psychosis;    Diagnosis;    Depression;    Mania;    Psychosis;   

DOI  :  10.1016/j.schres.2013.02.036

来源: Elsevier

【 摘 要 】

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. (C) 2013 Elsevier B. V. All rights reserved.

【 授权许可】

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