Does schizoaffective disorder really exist? A systematic review of the studies that compared schizoaffective disorder with schizophrenia or mood disorders

Cheniaux, Elie; Landeira-Fernández, J.; Telles, Leonardo Lessa; Lessa, José Luiz Martins; Dias, Allan; Duncan, Teresa T.; Versiani, Márcio

doi:10.1016/j.jad.2007.07.009

Cited by 153 publications

(118 citation statements)

References 53 publications

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“…They are clearly incompatible with the argument that schizoaffective disorder is a variant of bipolar disorder 5, 48, 49. Nor are they easy to reconcile with the longstanding—and currently highly topical—proposal that schizoaffective disorder represents the midpoint along a continuum of psychosis, as conceptualized either genetically 6, 13, clinically 8, 50, 51, or both 52. This would predict less volume change in schizoaffective disorder than in schizophrenia, something that none of the analyses carried out in this study supported.…”

Section: Discussionmentioning

confidence: 96%

“…At various times, it has been argued that it should be considered an independent diagnostic entity 3, a variant of schizophrenia 4, a variant of affective disorder 5, the midpoint on a continuum between the two 6, or even a disorder which does not really exist 7. Clinical studies have performed little to clarify the status of the disorder, finding that it does not clearly separate from schizophrenia or bipolar disorder, either cross‐sectionally 8, 9, or in terms of its course and outcome (for a review, see 10). Similarly, family history studies have found high rates of affective disorders in the first‐degree relatives of patients with schizoaffective disorder, but also elevated rates of schizophrenia 11, 12, 13, 14.…”

Section: Introductionmentioning

confidence: 99%

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Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Amann

Canales‐Rodríguez

Madre

et al. 2015

Acta Psychiatr Scand

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ObjectiveBrain structural changes in schizoaffective disorder, and how far they resemble those seen in schizophrenia and bipolar disorder, have only been studied to a limited extent.MethodForty‐five patients meeting DSM‐IV and RDC criteria for schizoaffective disorder, groups of patients with 45 matched schizophrenia and bipolar disorder, and 45 matched healthy controls were examined using voxel‐based morphometry (VBM).ResultsAnalyses comparing each patient group with the healthy control subjects found that the patients with schizoaffective disorder and the patients with schizophrenia showed widespread and overlapping areas of significant volume reduction, but the patients with bipolar disorder did not. A subsequent analysis compared the combined group of patients with the controls followed by extraction of clusters. In regions where the patients differed significantly from the controls, no significant differences in mean volume between patients with schizoaffective disorder and patients with schizophrenia in any of five regions of volume reduction were found, but mean volumes in the patients with bipolar disorder were significantly smaller in three of five.ConclusionThe findings provide evidence that, in terms of structural gray matter brain abnormality, schizoaffective disorder resembles schizophrenia more than bipolar disorder.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Amann

Canales‐Rodríguez

Madre

et al. 2015

Acta Psychiatr Scand

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“…Schizophrenia has been documented in all ethnic groups investigated to date (22). Schizoaffective disorder (SZA) is a related, common disorder that lies on a continuum between SZ and bipolar I disorder (BP1) with regard to its clinical features and possibly also in relation to etiology (7,32).…”

Section: Clinical Featuresmentioning

confidence: 99%

Genetic Association Studies of Antioxidant Pathway Genes and Schizophrenia

Chowdari

Bamne²,

Nimgaonkar³

2011

Antioxidants & Redox Signaling

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The endogenous production of highly reactive oxidation species is an inherent by-product of cellular energy metabolism. Cellular antioxidant defense systems (AODS) comprising various antioxidants counter these damaging effects. Several lines of evidence, including postmortem studies, suggest increased oxidative stress in patients with schizophrenia. Some genetic association studies and gene-expression studies suggest that patients also may have altered ability to mount antioxidative mechanisms. As the genetic associations may provide etiologic evidence in support of the oxidative-stress hypothesis of schizophrenia, a focused review has been conducted. We also suggest avenues for further research. Antioxid. Redox Signal. 15, 2037Signal. 15, -2045

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“…[4][5][6][7] Persons with schizoaffective disorder experience significant functional impairment 4,8 and higher rates of hospitalization, suicidality, and substance abuse than persons with schizophrenia. 9 Optimal management of schizoaffective disorder requires long-term treatment, and its prognosis is intermediate to that of schizophrenia and affective disorders. 4,8,10,11 To manage psychotic, depressive, and manic symptoms, schizoaffective disorder is treated with complex pharmacologic regimens that include antipsychotics, mood stabilizers, and antidepressants.…”

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confidence: 99%

Paliperidone Palmitate Once-Monthly Reduces Risk of Relapse of Psychotic, Depressive, and Manic Symptoms and Maintains Functioning in a Double-Blind, Randomized Study of Schizoaffective Disorder

Fu¹,

Turkoz²,

Simonson³

et al. 2014

J. Clin. Psychiatry

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Objective: Schizoaffective disorder is a complex illness for which optimal treatment is not well established. Results of the first controlled, relapse-prevention study of paliperidone palmitate once-monthly injectable (paliperidone monthly) in schizoaffective disorder are presented. Method:The study was conducted between September 20, 2010, and October 22, 2013. Patients with schizoaffective disorder (confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders) experiencing acute exacerbation of psychotic and depressive/manic symptoms were stabilized with paliperidone monthly as monotherapy or as adjunctive therapy to mood stabilizers or antidepressants and randomly assigned (1:1) to paliperidone monthly or placebo in a 15-month, double-blind, relapse-prevention phase. Randomization was stratified by administration as monotherapy or adjunctive therapy and by study center. The primary endpoint was time to relapse.Results: 334 patients were evaluated. Paliperidone monthly significantly delayed time to relapse for psychotic, depressive, and manic symptoms compared with placebo (P < .001, log-rank test). Relapse risk was 2.49 times greater for placebo (hazard ratio = 2.49; 95% CI, 1.55 to 3.99; P < .001, Cox proportional hazards model). Overall relapse rates were 33.5% for placebo and 15.2% for paliperidone monthly. For monotherapy, relapse risk was 3.38 times greater with placebo (P = .002), and for adjunctive treatment it was 2.03 times greater with placebo (P = .021). Paliperidone monthly was superior to placebo in maintaining functioning as measured by the Personal and Social Performance scale (P = .014, mixed-model repeated-measures analysis). The most common adverse events (placebo, paliperidone monthly) were increased weight (4.7%, 8.5%), insomnia (7.1%, 4.9%), schizoaffective disorder (5.9%, 3.0%), headache (3.5%, 5.5%), and nasopharyngitis (3.5%, 5.5%). Incidence of any extrapyramidal-related adverse event was 7.1% for placebo and 8.5% for paliperidone monthly.Conclusions: Paliperidone monthly as monotherapy or adjunctive therapy significantly delayed psychotic, depressive, and/or manic relapses; reduced their risk; and better maintained functioning in patients with schizoaffective disorder. Results support the value of maintenance treatment with paliperidone monthly in schizoaffective disorder.Trial Registration: ClinicalTrials.gov identifier: NCT01193153 Clin Psychiatry 2015;76(3):253-262 J

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Does schizoaffective disorder really exist? A systematic review of the studies that compared schizoaffective disorder with schizophrenia or mood disorders

Cited by 153 publications

References 53 publications

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Genetic Association Studies of Antioxidant Pathway Genes and Schizophrenia

Paliperidone Palmitate Once-Monthly Reduces Risk of Relapse of Psychotic, Depressive, and Manic Symptoms and Maintains Functioning in a Double-Blind, Randomized Study of Schizoaffective Disorder

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