Course of Affective and Schizoaffective Disorders

  • A. Rohde
  • A. Marneros
  • A. Deister
  • H. Jünemann
  • B. Staab

Abstract

In the discussion on the question of how to classify schizoaffective disorders — i.e., as a subgroup of one of the major functional psychoses or as a separate nosological entity — a position often taken in recent years is that schizoaffective disorders appear at least partially to be subtypes of affective disorders (Levinson and Levitt 1987; Sovner and McHugh 1976; Winokur 1984; Winokur et al., this volume). One of the reasons for this point of view is that several studies have shown similarities in course between affective and schizoaffective disorders, for instance, the well-known Zurich studies of Angst and coworkers (Angst 1980; Angst et al. 1973, 1980) or the Cologne Study of Marneros and coworkers (Marneros et al. 1988a–d). Regarding affective disorders, there has been general agreement in recent years that the unipolar and bipolar forms should be investigated separately because of several relevant differences (Angst 1966, 1987). Recent work shows that the subgrouping of schizoaffective disorders — similarly to affective disorders — into unipolar and bipolar forms is also indicated (Angst 1989, Marneros et al. 1989a–c). The differentiation between unipolar and bipolar forms of affective and schizoaffective disorders is necessary not only because of relevant differences in premorbid, sociodemographic, and therapeutic aspects, but also considering the longitudinal approach. Conversely, the division of schizoaffective disorders into schizodepression and schizomania (Brockington et al. 1980; Maj 1985) has the disadvantage of taking only the cross-sectional aspect into consideration (Marneros et al. 1986a–c, 1989b). The division of affective and schizoaffective disorders into unipolar and bipolar forms also solves the problem of syndrome shift and polymorphism of the course (Marneros et al. 1988d).

Keywords

Depression Lithium Schizophrenia Neurol Propyl 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Angst J (1966) Zur Ätiologie und Nosologie endogener depressiver Psychosen. Eine gene-tische, soziologische und klinische Studie. Springer, Berlin Heidelberg New YorkGoogle Scholar
  2. Angst J (1980) Verlauf unipolar depressiver, bipolar manisch-depressiver and schizo-affektiver Erkrankungen und Psychosen. Fortschr Neurol Psychiatr 48: 3–30CrossRefGoogle Scholar
  3. Angst J (1986) The course of schizoaffective disorders. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New YorkGoogle Scholar
  4. Angst J (1987) Verlauf der affektiven Psychosen. In: Kisker KP, Lauter H, Meyer J-E, Müller C, Strömgren E (eds) Psychiatrie der Gegenwart, vol 5, 3rd edn. Springer, Berlin Heidelberg New YorkGoogle Scholar
  5. Angst J (1989) Der Verlauf schizoaffektiver Psychosen. In: Marneros A (ed) Schizoaffektive Psychosen. Therapie und Prophylaxe. Springer, Berlin Heidelberg New YorkGoogle Scholar
  6. Angst J, Weis P (1967) Periodicity of depressive psychoses. In: Brill H, Cole JO, Deniker P, Hippius H, Bradley BP (eds) Neuro-psychopharmacology. Proceedings of the fifth international congress of the Collegium. Internationale Neuro-Psychopharmacologicum, Washington DC 1966. Excerpta Medica, AmsterdamGoogle Scholar
  7. Angst J, Baastrup P, Grof P, Hippius H, Pöldinger W, Weis P (1973) The course of monopolarGoogle Scholar
  8. depression and bipolar psychoses. Psychiatr Neurol Neurochir 76:489–500Google Scholar
  9. Angst J, Felder W, Lohmeyer B (1980) Course of schizoaffective psychoses: results of a follow-up study. Schizophr Bull 6: 579–585PubMedGoogle Scholar
  10. Bastianello RR, Janiri L, Mauro P, Pirrongelli C (1985) Slow-release lithium in treatment of schizoaffective syndromes. Int J Clin Pharmacol Res 5: 205–211PubMedGoogle Scholar
  11. Brockington I, Wainwright S, Kenell R (1980) Depressed patients with schizophrenic or paranoid symptoms. Psychol Med 10: 665–675PubMedCrossRefGoogle Scholar
  12. Bunney WE, Brodie KH, Murphy DL, Goodwin FK (1970) Psychopharmacological differentiation between two subgroups of depressed patients. Proceedings of the 78th Annual Convention of the APAGoogle Scholar
  13. Küfferle B, Lenz G (1983) Classification and course of schizo-affective psychoses. Psychiatr Clin (Basel) 16: 169–177Google Scholar
  14. Levinson DF, Levitt MEM (1987) Schizoaffective mania reconsidered. Am J Psychiatry 144: 415–425PubMedGoogle Scholar
  15. Maj M (1985) Clinical course and outcome of schizoaffective disorders. Acta Psychiatr Scand 72: 542–550PubMedCrossRefGoogle Scholar
  16. Marneros A, Deister A, Rohde A (1986a) The Cologne study on schizoaffective disorders and schizophrenia suspecta. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New YorkCrossRefGoogle Scholar
  17. Marneros A, Rohde A, Deister A, Risse A (1986b) Features of schizoaffective disorders. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New YorkCrossRefGoogle Scholar
  18. Marneros A, Rohde A, Deister A, Risse A (1986c) Schizoaffective disorders: the prognostic value of the affective component. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New YorkCrossRefGoogle Scholar
  19. Marneros A, Deister A, Rohde A, Jünemann H, Fimmers R (1988a) Long-term course of schizoaffective disorders. I. Definitions, methods, frequency of episodes and cycles. Eur Arch Psychiatry Neurol Sci 237: 264–275Google Scholar
  20. Marneros A, Rohde A, Deister A, Jünemann H, Fimmers R (1988b) Long-term course of schizoaffective disorders. II. Length of cycles, episodes, and intervals. Eur Arch Psychiatry Neurol Sci 237: 276–282Google Scholar
  21. Marneros A, Rohde A, Deister A, Fimmers R, Jünemann H (1988c) Long-term course of schizoaffective disorders. III. Onset, type of episodes and syndrome shift, precipitating factors, suicidality, seasonality, inactivity of illness, and outcome. Eur Arch Psychiatry Neurol Sci 237: 283–290Google Scholar
  22. Marneros A, Rohde A, Deister A, Jünemann H (1988d) Syndrome shift in long-term course of schizoaffective disorders. Eur Arch Psychiatry Neurol Sci 238: 97–104PubMedGoogle Scholar
  23. Marneros A, Deister A, Rohde A (1989a) Unipolar and bipolar schizoaffective disorders: a comparative study. I. Premorbid and sociodemographic features. Eur Arch Psychiatry Neurol Sci 239: 158–163Google Scholar
  24. Marneros A, Rohde A, Deister A (1989b) Unipolar and bipolar schizoaffective disorders: a comparative study. II. Long-term course. Eur Arch Psychiatry Neurol Sci 239: 164–170Google Scholar
  25. Marneros A, Deister A, Rohde A, Jünemann H (1989c) Unipolar and bipolar schizoaffective disorders: a comparative study. III. Long-term outcome. Eur Arch Psychiatry Neurol 239: 171–176Google Scholar
  26. Marneros A, Rohde A, Deister A, Steinmeyer A (1990) Behinderung und Residuum bei schizoaffektiven Psychosen: Daten, methodische Probleme und Hinweise für zukünftige Forschung. Fortschr Neurol Psychiatr 58: 66–75Google Scholar
  27. Mendlewicz J, Fieve RR, Stallone F (1973) Relationship between effectiveness of lithium therapy and family history. Am J Psychiatry 130: 1011–1013PubMedGoogle Scholar
  28. Rzewuska M, Angst J (1982) Prognosis of periodic bipolar manic-depressive and schizoaffective psychoses. Arch Psychiatr Nervenkr 231: 471–486PubMedCrossRefGoogle Scholar
  29. Sovner RD, McHugh PR (1976) Bipolar course in schizo-affective illness. Biol Psychiatry 11: 195–204PubMedGoogle Scholar
  30. Weiner A, Croughan J, Fishman R. Robins E (1977) The group of schizoaffective and related psychoses: a follow-up study. Compr Psychiatry 18: 413–422CrossRefGoogle Scholar
  31. Winokur G (1984) Psychosis in bipolar and unipolar affective illness with special reference to schizoaffective disorder. Br J Psychiatr 145: 236–242CrossRefGoogle Scholar
  32. Zvolsky P, Vinarova E, Dostal T, Soucek K (1974) Family history of manic-depressive and endogenous patients and clinical effect of treatment with lithium. Act Nery Super (Praha) 16: 194–195Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • A. Rohde
  • A. Marneros
  • A. Deister
  • H. Jünemann
  • B. Staab
    • 1
  1. 1.Psychiatrische UniversitätsklinikBonn 1Germany

Personalised recommendations