Miller Jacob N, Black Donald W
University of Iowa Carver College of Medicine, Iowa City, IA 52242. E-MAIL:
Ann Clin Psychiatry. 2019 Feb;31(1):47-53.
Schizoaffective disorder (SAD) is a chronic, potentially disabling psychotic disorder common in clinical settings. SAD often has been used as a diagnosis for individuals having an admixture of mood and psychotic symptoms whose diagnosis is uncertain. Its hallmark is the presence of symptoms of a major mood episode (either a depressive or manic episode) concurrent with symptoms characteristic of schizophrenia, such as delusions, hallucinations, or disorganized speech.
A literature search in PubMed and Google Scholar was conducted to identify articles on SAD. We also reviewed major textbooks and DSM-5 to identify pertinent information.
This review begins with the history and classification of SAD. Debate continues to swirl around the concept, as some experts view SAD as an independent disorder, while others see SAD as either a form of schizophrenia or a mood disorder. The disorder is more common in women and its course follows the middle ground between schizophrenia and bipolar disorder. SAD appears to have high heritability. Most patients appear to benefit from antipsychotics plus antidepressants and/or mood stabilizers, depending on whether the patient has the depressive or bipolar subtype. Electroconvulsive therapy can also be effective.
SAD is a chronic psychotic disorder that continues to be controversial. There has been inadequate research regarding its epidemiology, course, etiologic factors, and treatment.
分裂情感性障碍(SAD)是一种慢性、可能导致残疾的精神病性障碍,在临床环境中很常见。SAD常被用于诊断那些情绪和精神病性症状混合、诊断不明确的个体。其标志是存在与精神分裂症特征性症状(如妄想、幻觉或言语紊乱)同时出现的主要情绪发作症状(抑郁发作或躁狂发作)。
在PubMed和谷歌学术上进行文献检索,以识别关于SAD的文章。我们还查阅了主要教科书和《精神疾病诊断与统计手册》第5版(DSM - 5)以获取相关信息。
本综述从SAD的历史和分类开始。围绕这一概念的争论仍在继续,一些专家将SAD视为一种独立的疾病,而另一些专家则认为SAD要么是精神分裂症的一种形式,要么是一种情绪障碍。该疾病在女性中更为常见,其病程介于精神分裂症和双相情感障碍之间。SAD似乎具有较高的遗传性。大多数患者似乎受益于抗精神病药物加抗抑郁药物和/或心境稳定剂,这取决于患者是抑郁亚型还是双相亚型。电休克治疗也可能有效。
SAD是一种慢性精神病性障碍,仍然存在争议。关于其流行病学、病程、病因因素和治疗的研究不足。