Evans J D, Heaton R K, Paulsen J S, McAdams L A, Heaton S C, Jeste D V
Department of Psychiatry, University of California, San Diego, USA.
J Clin Psychiatry. 1999 Dec;60(12):874-82.
The diagnostic status of schizoaffective disorder continues to be controversial. Researchers have proposed that schizoaffective disorder represents a variant of schizophrenia or affective disorder, a combination of the 2, or an intermediate condition along a continuum between schizophrenia and affective disorder.
We compared outpatients aged 45 to 77 years with DSM-III-R diagnosis of schizoaffective disorder (N = 29), schizophrenia (N = 154), or nonpsychotic mood disorder (N = 27) on standardized rating scales of psychopathology and a comprehensive neuropsychological test battery. A discriminant function analysis was used to classify the schizoaffective patients based on their neuropsychological profiles as being similar either to schizophrenia patients or to those with nonpsychotic mood disorder.
The schizoaffective and schizophrenia patients had more severe dyskinesia, had a weaker family history of mood disorder, had been hospitalized for psychiatric reasons more frequently, were more likely to be prescribed neuroleptic and anticholinergic medication, and had somewhat less severe depressive symptoms than the mood disorder patients. The schizophrenia patients had more severe positive symptoms than the schizoaffective and mood disorder patients. The neuropsychological performances of the 2 psychosis groups were more impaired than those of the nonpsychotic mood disorder patients. Finally, on the basis of a discriminant function analysis, the schizoaffective patients were more likely to be classified as having schizophrenia than a mood disorder.
These findings suggest that schizoaffective disorder may represent a variant of schizophrenia in clinical symptom profiles and cognitive impairment.
分裂情感性障碍的诊断状况一直存在争议。研究人员提出，分裂情感性障碍代表精神分裂症或情感障碍的一种变体、两者的结合，或是精神分裂症和情感障碍之间连续谱上的一种中间状态。
我们将年龄在45至77岁之间、根据《精神疾病诊断与统计手册第三版修订本》（DSM - III - R）诊断为分裂情感性障碍（N = 29）、精神分裂症（N = 154）或非精神病性心境障碍（N = 27）的门诊患者，在精神病理学标准化评定量表和一套全面的神经心理学测试组上进行比较。采用判别函数分析，根据神经心理学特征将分裂情感性障碍患者分类，看其与精神分裂症患者还是与非精神病性心境障碍患者更为相似。
与心境障碍患者相比，分裂情感性障碍和精神分裂症患者有更严重的运动障碍，心境障碍家族史较弱，因精神科原因住院更频繁，更可能被开具抗精神病药物和抗胆碱能药物，且抑郁症状稍轻。精神分裂症患者的阳性症状比分裂情感性障碍和心境障碍患者更严重。两个精神病组的神经心理学表现比非精神病性心境障碍患者受损更严重。最后，基于判别函数分析，分裂情感性障碍患者比心境障碍患者更有可能被归类为患有精神分裂症。
这些发现表明，分裂情感性障碍在临床症状特征和认知损害方面可能代表精神分裂症的一种变体。
