Béguin T
Clinique des Maladies Mentales et de l'Encéphale, Centre Hospitalier Sainte-Anne, Paris.
Encephale. 1994 Jul-Aug;20(4):385-92.
Schizo-affective psychosis raises the nosological problem of the boundaries between the schizophrenia and the affective disorders. In the french classification (I.N.S.E.R.M., 1968) there is only the group of "chronic schizophrenia with mood disorders". In the DSM III-R the schizo-affective psychosis has its own criteria for the first time. A brief historical survey reveals the vicissitudes of the evolution of this american concept. J. Kasanin first proposed this term in 1932 to differentiate from the dementia praecox a group of cases with good prognosis. For all that, the schizo-affective psychosis remained included in the schizophrenia illness until the DSMII (1968). Under the influence of factors (principally the international comparative studies of diagnosis of mental disorders) the american psychiatry reconsidered its system of classification and elaborated the Research Diagnosis Criteria (Spitzer, 1975). The first studies quickly led to an opposite position because the schizo-affective psychosis became principally a subgroup of the affective disorders (DSM III, 1980). The studies of the last ten years generally criticized this new classification. Among the schizo-affective group they tried to separate the schizophrenic cases from the affective cases by subdivisions according different axes (mainly schizophrenic vs mainly affective, manic type vs depressive type, unipolar type vs bipolar type). Today the review of these studies did not lead to resolve the nosological problem. However the studies corroborate the model that schizo-affective illness is a heterogeneous disorder with schizophrenic cases and affective cases.
分裂情感性精神病引发了精神分裂症与情感障碍之间界限的疾病分类学问题。在法国的分类系统（法国国家卫生与医学研究所，1968年）中，只有“伴有情绪障碍的慢性精神分裂症”这一组。在《精神疾病诊断与统计手册》第三版修订本（DSM III-R）中，分裂情感性精神病首次有了自己的诊断标准。一项简要的历史回顾揭示了这一美国概念演变的沧桑历程。J. 卡萨宁于1932年首次提出这个术语，以区分出一组预后良好的病例与早发性痴呆。尽管如此，直到《精神疾病诊断与统计手册》第二版（1968年），分裂情感性精神病仍被纳入精神分裂症疾病范畴。在美国精神病学受到诸多因素影响（主要是精神障碍诊断的国际比较研究）后，重新审视了其分类系统并制定了研究诊断标准（斯皮策，1975年）。最初的研究很快得出了相反的结论，因为分裂情感性精神病主要变成了情感障碍的一个亚组（《精神疾病诊断与统计手册》第三版，1980年）。过去十年的研究普遍对这种新分类提出批评。在分裂情感性精神病组中，他们试图通过根据不同轴进行细分（主要是精神分裂症型与主要是情感障碍型、躁狂型与抑郁型、单相型与双相型）来区分精神分裂症病例和情感障碍病例。如今，对这些研究的回顾并未解决疾病分类学问题。然而，这些研究证实了分裂情感性疾病是一种包含精神分裂症病例和情感障碍病例的异质性疾病这一模型。
