Marneros A, Rohde A, Deister A, Steinmeyer E M
Universitäts-Nervenklinik Bonn.
Fortschr Neurol Psychiatr. 1990 Feb;58(2):66-75. doi: 10.1055/s-2007-1001171.
Schizoaffective disorders take a position between schizophrenia and affective disorders regarding outcome in the sense of psychological residuum and social consequences. What prognosis a schizoaffective illness has depends mainly on intrasymptomatological factors: Melancholic episodes during course seem to predict a good long-term outcome, schizophrenia-typical symptoms in the opposite predestinate to the development of residuum and disability. Non-symptomatological factors do not have any direct influence on the development of a residuum and disability. The comparison of course studies is limited by severe difficulties based on methodological and definitional shortcomings. Such shortcomings are (a) broad definition of schizoaffective but also of schizophrenic psychoses, (b) globalization of the term "outcome", (c) partialization of the term "prognosis", (d) equalization of the terms "course" and "outcome", (e) ignoring of inhomogeneity and polymorphism of schizoaffective disorders, (f) global evaluation of "outcome", (g) short follow-up periods. Some suggestions how to limitate the mentioned methodological shortcomings are discussed.
分裂情感性障碍在心理残留和社会后果方面的结局介于精神分裂症和情感性障碍之间。分裂情感性疾病的预后主要取决于症状内因素:病程中出现的抑郁发作似乎预示着良好的长期结局,而典型的精神分裂症症状则相反,预示着残留症状和残疾的发展。非症状因素对残留症状和残疾的发展没有直接影响。由于方法学和定义上的缺陷,病程研究的比较受到严重困难的限制。这些缺陷包括:(a) 对分裂情感性障碍以及精神分裂症性精神病的宽泛定义;(b) “结局”一词的泛化;(c) “预后”一词的片面化;(d) “病程”和“结局”这两个术语的等同化;(e) 忽视分裂情感性障碍的异质性和多态性;(f) 对“结局”的整体评估;(g) 随访期短。本文讨论了一些如何限制上述方法学缺陷的建议。