Schizoaffective Psychosis: Questions and Directions

  • M. T. Tsuang
  • A. Marneros

Abstract

Although a long tradition in psychiatry supports the distinctiveness of schizophrenia and affective illness (Kraepelin 1919), it has also long been noted that there is a large group of patients who manifest the symptoms or characteristics of both major disorders. These patients present a conceptual problem to theorists, a therapeutic problem to clinicians, and a diagnostic problem to researchers. This last is perhaps the most troublesome, since it is to research that we must turn if we are to refine our conceptions of psychiatric illness or improve the efficacy of our treatment. One major difficulty with research concerned with classifying these mixed-symptom patients is that concurrent efforts must be undertaken to discover both the characteristics of the group and to establish the validity of the operational criteria for inclusion in the group; yet, these activities are mutually dependent. Furthermore, the criteria for schizoaffective disorders have varied widely. Research results, accordingly, have been inconclusive and sometimes contradictory. For a perspective on this difficulty and the variety of efforts that have been made to resolve it, we review below the work of other theorists and researchers.

Keywords

Depression Dementia Schizophrenia Neurol Posite 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. APA, Washington D.C.Google Scholar
  2. Angst J (1986) The Course of Schizoaffective Disorders. In: Marneros A, Tsuang MT (eds) The schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  3. Angst J, Felder W, Frey R, Stassen HH (1978) The course of affective disorders: I. Change ofdiagnosis of monopolar, unipolar and bipolar illness. Arch Psychiatr Nervenkr 226:57–64Google Scholar
  4. Angst J, Felder W, Lohmeyer B (1979) Schizoaffective disorders: I. Results of a genetic investi-gation. J Aff Dis 1:139–153Google Scholar
  5. Astrup C, Noreik K (1966) Functional psychoses: diagnostic and prognostic models. Charles C Thomas, Springfield, ILGoogle Scholar
  6. Bleuler E (1924) Textbook of Psychiatry. Translation of 4th German edn by AA Brill. Macmillan, New YorkGoogle Scholar
  7. Brockington IF, Leff JR (1979) Schizo-affective psychosis: Definitions and incidence. Psychol Med 9: 91–99Google Scholar
  8. Brockington IF, Kendell RE, Wainwright S (1980 a) Depressed patients with schizophrenic or paranoid symptoms. Psychol Med 10: 665–675CrossRefGoogle Scholar
  9. Brockington IF, Wainwright S, Kendell RE (1980 b) Manic patients with schizophrenic or paranoid symptoms. Psychol Med 10: 73–83CrossRefGoogle Scholar
  10. Himmelhoch JA, Fuchs CZ, May SJ, Symons BJ, Neil JF (1981) When a schizoaffective diagnosis has meaning. J Nery Ment Dis 169: 277–282CrossRefGoogle Scholar
  11. Kant 0 (1940) Types and analyses of the clinical pictures of recovered schizophrenics. Psychiat Q 14: 676–700CrossRefGoogle Scholar
  12. Kasanin J (1933) The acute schizoaffective psychoses. Am J Psychiatry 13: 97–126Google Scholar
  13. Kendell RE, Gourlay J (1970) The clinical distinction between affective psychoses and schizophrenia. Br J Psychiat 117: 261–266Google Scholar
  14. Kraepelin E (1919) Dementia praecox and paraphrenia. E & S Livingston, Edinburgh Langfeldt G (1937) The prognosis in schizophrenia and the factors influencing the course of the disease. Acta Psychiat Neurol Scand [Suppl] 13: 1–128Google Scholar
  15. Leonhard K (1957) Aufteilung der endogenen Psychosen. Akademie, JenaGoogle Scholar
  16. Mameros A, Deister A, Rohde A ( 1986 a) The Cologne study on schizoaffective disorders and schizophrenia suspecta. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  17. Mameros A, Rohde A, Deister A, Risse A ( 1986 b) Features of schizoaffective disorders - the “cases-in-between” - In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  18. Mendlewicz J, Linkowski P, Wilmotte J (1980) Relationship between schizoaffective illness and affective disorders or schizophrenia: Morbidity risk and genetic transmission. J Aff Dis 2: 289–302Google Scholar
  19. Perris C (1966) A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. Acta Psychiat Scand [Suppl] 194Google Scholar
  20. Perris C (1974) A study of cycloid psychoses. Acta Psychiat Scand [Suppl] 253Google Scholar
  21. Perris C (1986) The case for the independence of cycloid psychotic disorder from the schizoaffective disorders. In: Mameros A, Tsuang MT (eds) The schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  22. Pichot P (1986) A comparison of different national concepts of schizoaffective psychosis. In: Marneros A, Tsuang MT (eds) The schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  23. Schneider K (1973) Klinische Psychopathologie, 10th edn. Thieme, StuttgartGoogle Scholar
  24. Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria: Rationale and reliability. Arch Gen Psychiat 35: 773–782Google Scholar
  25. Stephens JH, Astrup C, Mangrum JC (1966) Prognostic factors in recovered and deteriorated schizophrenics. Am J Psychiat 122: 1116–1121PubMedGoogle Scholar
  26. Strömgren E (1986) Reactive (psychogenic) psychoses and their relations to schizoaffective psychoses. In: Mameros A, Tsuang MT (eds) The schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  27. Tsuang MT, Dempsey GM, Rausher F (1976) A study of `atypical schizophrenia’: Comparison with schizophrenia and affective disorder by sex, age of admission, precipitant, outcome, and family history. Arch Gen Psychiat 33: 1157–1160Google Scholar
  28. Tsuang MT, Simpson JC, Fleming JA (1986) Diagnostic criteria for subtyping schizoaffective disorder. In: Mameros A, Tsuang MT (eds) The schizoaffective psychoses. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  29. Vaillant GE (1962) The prediction of recovery in schizophrenia. J Nerv Ment Dis 135:534–543 Weiner A, Croughan J, Fishman R, Robins E (1977) The group of schizoaffective and related psychoses: A follow-up study. Comp Psychiat 18: 413–422Google Scholar
  30. Welner A, Weiner Z, Fishman R (1979) The group of schizoaffective and related psychoses: IV. A family study. Comp Psychiat 20: 21–25Google Scholar
  31. Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, LondonGoogle Scholar
  32. World Health Organization (1979) Mental disorders: Glossary and guide to their classification in accordance with the 9th revision of the international classification of diseases. WHO, GenevaGoogle Scholar

Copyright information

© Springer-Verlag Berlin-Heidelberg 1986

Authors and Affiliations

  • M. T. Tsuang
    • 1
  • A. Marneros
    • 2
  1. 1.Harvard Program in Psychiatric Epidemiology, Harvard Schools of Medicine and Public Health; the Psychiatry Service and the Center for Mental Health and Behavioral SciencesBrockton-West Roxbury VA Medical CenterBrocktonUSA
  2. 2.Department of PsychiatryUniversity of BonnBonn 1Germany

Personalised recommendations