Marneros A, Deister A, Rohde A
Universitäts-Nervenklinik, Bonn, Federal Republic of Germany.
Eur Arch Psychiatry Neurol Sci. 1988;238(2):97-104. doi: 10.1007/BF00452784.
Seventy-two patients diagnosed as having schizoaffective disorders (Cologne study) were investigated with regard to syndrome shift. During long-term follow-up (mean 25.6 years) they had 400 episodes (the duration of an episode being defined as the time between the beginning and end of inpatient or inpatient-like treatment). A total of 61% of the patients had a polymorphous course, i.e. displayed more than one type of episode. The first syndrome shift was found in the early stages of the course (in 61% of the cases as early as the second episode, in 84% at latest by the third episode). Using diagnostic criteria considering the longitudinal approach, 88% of schizoaffective disorders could be definitively diagnosed as such at the latest by the second episode. The only difference in the course between polymorphous and monomorphous (with only one type of episode) schizoaffective disorders was that the former relapsed more frequently. On the basis of the findings of the present study we suggest a longitudinally based dichotomy of schizoaffective disorders into bipolar and unipolar.
对72例被诊断为分裂情感性障碍的患者（科隆研究）进行了综合征转变方面的调查。在长期随访（平均25.6年）期间，他们经历了400次发作（一次发作的持续时间定义为住院或类似住院治疗开始至结束的时间）。共有61%的患者病程呈多形性，即表现出不止一种类型的发作。首次综合征转变出现在病程早期（61%的病例最早在第二次发作时出现，84%的病例最迟在第三次发作时出现）。采用考虑纵向病程的诊断标准，88%的分裂情感性障碍最迟在第二次发作时可明确诊断为此类疾病。多形性和单形性（仅有一种发作类型）分裂情感性障碍在病程上的唯一区别在于前者复发更频繁。基于本研究的结果，我们建议将分裂情感性障碍基于纵向病程分为双相型和单相型。
