Biological Studies of Schizoaffective Disorders

Abstract

Biological studies of the relationships between the schizoaffective disorders, the affective disorders, and schizophrenia suggest that no simple reductionist model is supported by currently available data. Thus, both affective and schizoaffective patients but not schizophrenics, manifest abnormalities such as decreased platelet serotonin (5-HT) uptake, blunted clonidine-induced increase in serum growth hormone, shortened latency of rapid eye movement (REM) sleep, and increased REM density. However, there are some types of studies which show greater similarity between schizoaffective and schizophrenic patients than between schizoaffectives and affectives--e.g., increased cerebrospinal fluid (CSF) norepinephrine levels, increased platelet 5-HT content, and decreased prostaglandin E1-stimulated adenylate cyclase activity. Other types of studies show abnormalities common to all three groups of psychoses--e.g., eye tracking dysfunction, elevated CSF concentration of gamma-aminobutyric acid, and neuromuscular abnormalities. There are also abnormalities that have been reported to be present in only one type of the psychoses. Although none of these findings have been so unequivocally demonstrated that they can be considered to be firmly established, they do suggest that it is premature to conclude that the schizoaffective disorders are subtypes of the affective disorders. The possibility of a continuum model of the psychiatric psychoses of unknown etiology merits further consideration. Further biological studies of a broad range of psychiatric psychoses with inclusion of the schizoaffective categories appear indicated.

Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature

“…Studies of neurotransmitter function that include persons with schizoaffective disorder are few, and consist primarily of observational studies of cerebrospinal fluid (CSF) or serum neurotransmitter metabolites. In an earlier review, Meltzer and colleagues (1984) reported similar patterns of neurochemical abnormalities among persons with schizophrenia, bipolar disorder, and schizoaffective disorder. In that review, it was reported that CSF norepinephrine, prostaglandin E1, norepinephrine and PGE1 adenyl cyclase and platelet 5HT levels among persons with schizophrenia and schizoaffective disorder are similar, while platelet 5HT profiles are more alike among persons with bipolar disorder and schizoaffective disorder than those with schizophrenia.…”

Review: A systematic review of hypothalamic-pituitary-adrenal axis function in schizophrenia: implications for mortality

“…Of the 1949 medicated schizophrenia patients, 504 (25.9%) were classified as non-suppressors, suggesting that antipsychotic medications themselves had little effect on DST results. Several studies correlated symptoms such as depressive, negative and positive symptoms with DST outcomes, as Schlesser et al (1980) Mostly inpatients 0/48 (0%) -- Dewan et al (1982) Chronic SCH 6/20 (30%) -No association of post-DEX cortisol with HAM-D or BPRS Rothschild et al (1982) Psychotic inpatients 2/14 (14%) -- Castro et al (1983) Chronic SCH 7/23 (30%) -- Coppen et al (1983) Chronic SCH inpatients 10/46 (22%) -NS associated with negative not positive symptoms Targum (1983) Hospitalized SCH patients 1/14 (7%) - Banki et al (1984) Hospitalized, acutely psychotic 13/34 (38%) -Paranoid SCH < catatonic and hebephrenic Berger et al (1984) Admitted SCH patients 7/23(30%) on admission 4/21 (19%) 7-10 days later -- Hwang et al (1984) SCH inpatients 2/13 (15%) -- Meltzer et al (1984) No details 7/36 (19%) -- Munro et al (1984) Residual SCH outpatients 7/46 (15%) -NS associated with depressive symptoms Nelson et al (1984) Admitted SCH patients 4/14 (29%) -- Rihmer et al (1984) Paranoid SCH 1/20 (5%) -- Sauer et al (1984) Admitted SCH patients 5/20 (25%) -- Sawyer and Jeffries (1984) 20 SCH inpatients 7/20 (35%) -NS associated with melancholic depression not depressed mood Stokes et al (1984) Hospitalized chronic SCH 2/12 (17%) - Banki et al (1985) Recently hospitalized SCH -10/20 (50%) -Baumgartner et al…”

Developmental Processes in Schizophrenic Disorders: Longitudinal Studies of Vulnerability and Stress

“…The inclusion of RDC schizoaffective, mainly schizophrenic, cases in the schizophrenic sample reflects the view that some schizoaffective cases are similar to schizophrenic disorders, whereas others are similar to affective disorders (e.g., Baron et al 1982; Harrow and Grossman 1984; Meltzer et al 1984; Tsuang and Simpson 1984; Kendler et al 1986). We adopted the RDC standard for making this division.…”