MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK.
Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Schizophr Bull. 2021 Aug 21;47(5):1375-1384. doi: 10.1093/schbul/sbab036.
There is controversy about the status of schizoaffective disorder depressive-type (SA-D), particularly whether it should be considered a form of schizophrenia or a distinct disorder. We aimed to determine whether individuals with SA-D differ from individuals with schizophrenia in terms of demographic, premorbid, and lifetime clinical characteristics, and genetic liability to schizophrenia, depression, and bipolar disorder. Participants were from the CardiffCOGS sample and met ICD-10 criteria for schizophrenia (n = 713) or SA-D (n = 151). Two samples, Cardiff Affected-sib (n = 354) and Cardiff F-series (n = 524), were used for replication. For all samples, phenotypic data were ascertained through structured interview, review of medical records, and an ICD-10 diagnosis made by trained researchers. Univariable and multivariable logistic regression models were used to compare individuals with schizophrenia and SA-D for demographic and clinical characteristics, and polygenic risk scores (PRS). In the CardiffCOGS, SA-D, compared to schizophrenia, was associated with female sex, childhood abuse, history of alcohol dependence, higher functioning Global Assessment Scale (GAS) score in worst episode of psychosis, lower functioning GAS score in worst episode of depression, and reduced lifetime severity of disorganized symptoms. Individuals with SA-D had higher depression PRS compared to those with schizophrenia. PRS for schizophrenia and bipolar disorder did not significantly differ between SA-D and schizophrenia. Compared to individuals with schizophrenia, individuals with SA-D had higher rates of environmental and genetic risk factors for depression and a similar genetic liability to schizophrenia. These findings are consistent with SA-D being a sub-type of schizophrenia resulting from elevated liability to both schizophrenia and depression.
关于分裂情感性障碍抑郁型（SA-D）的地位存在争议，尤其是它是否应被视为精神分裂症的一种形式还是一种独特的障碍。我们旨在确定 SA-D 患者与精神分裂症患者在人口统计学、病前和终生临床特征以及精神分裂症、抑郁症和双相情感障碍的遗传易感性方面是否存在差异。参与者来自卡迪夫 COGS 样本，符合 ICD-10 精神分裂症标准（n = 713）或 SA-D 标准（n = 151）。使用两个样本，即卡迪夫受影响的同胞（n = 354）和卡迪夫 F 系列（n = 524）进行复制。对于所有样本，通过结构化访谈、病历审查和由训练有素的研究人员进行的 ICD-10 诊断来确定表型数据。使用单变量和多变量逻辑回归模型比较精神分裂症和 SA-D 患者的人口统计学和临床特征以及多基因风险评分（PRS）。在卡迪夫 COGS 中，与精神分裂症相比，SA-D 与女性、儿童期虐待、酒精依赖史、精神病最严重发作时的较高功能全球评估量表（GAS）评分、较差的功能 GAS 评分在抑郁最严重的发作时，以及一生中紊乱症状严重程度降低有关。与精神分裂症患者相比，SA-D 患者的抑郁 PRS 更高。SA-D 和精神分裂症之间的精神分裂症和双相情感障碍 PRS 没有显着差异。与精神分裂症患者相比，SA-D 患者具有更高的抑郁环境和遗传危险因素发生率，并且对精神分裂症的遗传易感性相似。这些发现与 SA-D 是精神分裂症的一种亚型一致，其原因是对精神分裂症和抑郁症的易感性增加。
