The Relationship of Schizoaffective Illnesses to Schizophrenic and Affective Disorders
The existence of patients who develop schizophrenic and affective symptoms simultaneously has always been puzzling, and a challenge to the Zweiteilungsprinzip enunciated by Kraepelin at the beginning of the century. Before the 1970s, such patients were rarely studied. The general assumption that schizophrenia and manic-depressive illness were distinct disease entities resulted in their being either ignored or included in one or the other of these major groupings and their atypical features glossed over. They have attracted more interest in the last 15 years, but their status is still uncertain, partly because the term schizoaffective has been applied by different authors to different kinds of patients. Some have used the term to describe those who develop schizophrenic and affective syndromes on separate occasions, and even the more numerous writers who have been concerned only with patients with concurrent schizophrenic and affective symptoms have applied the term to patients of varied kinds. The problem is that the concept of schizoaffective illness is at the mercy of variable concepts of schizophrenia and affective psychosis. A psychiatrist with a broad concept of both schizophrenia and affective psychosis has no need to use the term schizoaffective, whereas a psychiatrist with narrow concepts of both major syndromes has to apply the term schizoaffective, or some other alternative label, to a high proportion of the patients he sees. And there may be almost no overlap between the patients labelled as ‘schizoaffective’ by a psychiatrist with a broad concept of schizophrenia and a narrow one of affective psychosis, and those so labelled by a psychiatrist with a broad concept of affective psychosis and a narrow one of schizophrenia.
KeywordsDepression Lithium Schizophrenia Amphetamine Tricyclic
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