Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany.
Bipolar Disord. 2013 May;15(3):229-39. doi: 10.1111/bdi.12057. Epub 2013 Mar 26.
Information on basic demographic and clinical characteristics of schizoaffective disorder is sparse and subject to sampling bias and low diagnostic reliability. In the present study we aimed to: (i) estimate the demographic and clinical descriptors in schizoaffective disorder patients and (ii) compare the findings with those with schizophrenia and bipolar disorder.
To minimize sampling bias and low reliability, we systematically reviewed studies that simultaneously compared schizoaffective, schizophrenia, and bipolar disorder patients. We estimated demographic, clinical, and psychometric characteristics based on weighted pooling, and compared disorders by meta-analysis. We also estimated whether schizoaffective disorder is closer to schizophrenia or to bipolar disorder.
We identified 50 studies that included 18312 patients. Most characteristics of the 2684 schizoaffective disorder patients fell between those of 4814 diagnosed with bipolar disorder and 10814 with schizophrenia. However, the schizoaffective group had the highest proportion of women (52%), had the youngest age at illness onset (23.3 ± 3.8 years), and had the highest standardized ratings of psychosis and depression. Differences in pooled parameters between schizoaffective versus schizophrenia and versus bipolar disorder subjects were similar. Values for patients with schizoaffective disorders mostly were intermediate between schizophrenia and bipolar disorder. However, the majority of studies showed schizoaffective patients to be more like schizophrenia than bipolar disorder patients in seven out of nine demographic and clinical categories as well as in five out of eight psychometric measures. These results remained similar when we restricted the analyses to studies with psychotic bipolar disorder patients only or to studies using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IIIR and DSM-IV only.
The present study provided estimates of important characteristics of schizoaffective disorder - as balanced as possible in summarizing the findings from observational studies as unbiased as possible. The results did not support the hypothesis that schizoaffective disorder is primarily an affective disorder. The stronger resemblance of schizoaffective disorder to schizophrenia than to bipolar disorder needs further investigation.
精神分裂情感障碍的基本人口统计学和临床特征的信息很少，并且受到采样偏差和低诊断可靠性的影响。在本研究中，我们旨在：（i）评估精神分裂情感障碍患者的人口统计学和临床特征；（ii）与精神分裂症和双相情感障碍进行比较。
为了最大限度地减少采样偏差和低可靠性，我们系统地回顾了同时比较精神分裂情感障碍、精神分裂症和双相情感障碍患者的研究。我们根据加权汇总估计人口统计学、临床和心理计量学特征，并通过荟萃分析比较疾病。我们还估计精神分裂情感障碍更接近精神分裂症还是双相情感障碍。
我们确定了 50 项研究，共纳入 18312 名患者。2684 名精神分裂情感障碍患者的大多数特征介于 4814 名被诊断为双相情感障碍和 10814 名精神分裂症患者之间。然而，精神分裂情感障碍组的女性比例最高（52%），发病年龄最小（23.3±3.8 岁），精神病和抑郁症的标准化评分最高。精神分裂情感障碍与精神分裂症和双相情感障碍患者之间的汇总参数差异相似。精神分裂情感障碍患者的各项参数值大多介于精神分裂症和双相情感障碍之间。然而，在九个人口统计学和临床类别中的七个以及八个心理测量指标中的五个中，大多数研究显示精神分裂情感障碍患者更像精神分裂症患者而不是双相情感障碍患者。当我们仅将分析限制在有精神病性双相情感障碍患者的研究或仅使用《精神疾病诊断与统计手册》（DSM）-III-R 和 DSM-IV 的研究时，这些结果仍然相似。
本研究提供了精神分裂情感障碍重要特征的估计值，尽可能平衡地总结了观察性研究的结果，尽可能无偏地总结了观察性研究的结果。结果不支持精神分裂情感障碍主要是一种情感障碍的假设。精神分裂情感障碍与精神分裂症的相似性强于与双相情感障碍的相似性，需要进一步研究。
