Individualizing Treatment for Patients With Schizoaffective Disorder

Vieta, Eduard

doi:10.4088/jcp.9096tx5cc

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…The clinical concept of a subgroup of psychotic patients with prominent affective symptoms remains important , even though the available evidence does not indicate whether its neurobiological underpinnings are unique. This concept may still be relevant for clinical practice including therapeutic implications .…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: a systematic review

Madre

Canales‐Rodríguez

Ortíz-Gil³

et al. 2016

Acta Psychiatr Scand

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Section: Discussionmentioning

confidence: 99%

Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: a systematic review

Madre

Canales‐Rodríguez

Ortíz-Gil³

et al. 2016

Acta Psychiatr Scand

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“…It should be mentioned that most of the research concerns pure and classic BD-I patients, although there are some rare data concerning special populations such as BD-II [ 36 , 62 ], schizoaffective disorder [ 101 , 102 ], patients with high suicide risk [ 85 , 103 , 104 ] and patients with comorbid substance abuse [ 105 , 106 ].…”

Section: Discussionmentioning

confidence: 99%

Psychosocial treatment and interventions for bipolar disorder: a systematic review

et al. 2015

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BackgroundBipolar disorder (BD) is a chronic disorder with a high relapse rate, significant general disability and burden and with a psychosocial impairment that often persists despite pharmacotherapy. This indicates the need for effective and affordable adjunctive psychosocial interventions, tailored to the individual patient. Several psychotherapeutic techniques have tried to fill this gap, but which intervention is suitable for each patient remains unknown and it depends on the phase of the illness.MethodsThe papers were located with searches in PubMed/MEDLINE through May 1st 2015 with a combination of key words. The review followed the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement.ResultsThe search returned 7,332 papers; after the deletion of duplicates, 6,124 remained and eventually 78 were included for the analysis. The literature supports the usefulness only of psychoeducation for the relapse prevention of mood episodes and only in a selected subgroup of patients at an early stage of the disease who have very good, if not complete remission, of the acute episode. Cognitive-behavioural therapy and interpersonal and social rhythms therapy could have some beneficial effect during the acute phase, but more data are needed. Mindfulness interventions could only decrease anxiety, while interventions to improve neurocognition seem to be rather ineffective. Family intervention seems to have benefits mainly for caregivers, but it is uncertain whether they have an effect on patient outcomes.ConclusionThe current review suggests that the literature supports the usefulness only of specific psychosocial interventions targeting specific aspects of BD in selected subgroups of patients.

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“…Subpopulations at risk for worst outcomes should be defined in order to improve the prognostic value of a diagnosis. For instance, a careful evaluation of symptom dimensions would allow for better defining, addressing and managing critical treatment targets [28, 29].…”

Section: Discussionmentioning

confidence: 99%

A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients

Murru

Verdolini

Anmella

et al. 2019

European Psychiatry

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Background: Schizoaffective disorder, bipolar type (SAD) and bipolar disorder I (BD) present a large clinical overlap. In a 1-year follow-up, we aimed to evaluate days to hospitalization (DTH) and predictors of relapse in a SAD-BD cohort of patients. Methods: A 1-year, prospective, naturalistic cohort study considering DTH as primary outcome and incidence of direct and indirect measures of psychopathological compensation as secondary outcomes. Kaplan-Meyer survival analysis with Log-rank Mantel-Cox test compared BD/SAD subgroups as to DTH. After bivariate analyses, Cox regression was performed to assess covariates possibly associated with DTH in diagnostic subgroups. Results: Of 836 screened patients, 437 were finally included (SAD = 105; BD = 332). Relapse rates in the SAD sample was n = 26 (24.8%) vs. n = 41 (12.3%) in the BD sample (p = 0.002). Mean AE SD DTH were 312.16 AE 10.6 (SAD) vs. 337.62 AE 4.4 (BD) days (p = 0.002). Patients with relapses showed more frequent suicide acts, violent behaviors, and changes in pharmacological treatments (all p < 0.0005) in comparison to patients without relapse. Patients without relapses had significantly higher mean number of treatments at T0 (p = 0.010). Cox regression model relating the association between diagnosis and DTH revealed that BD had higher rates of suicide attempts (HR = 13.0, 95%CI = 4.0-42.0, p < 0.0005), whereas SAD had higher rates of violent behavior during psychotic episodes (HR = 12.0, 95%CI = .3.3-43.5, p > 0.0005). Conclusions: SAD patients relapse earlier with higher hospitalization rates and violent behavior during psychotic episodes whereas bipolar patients have more suicide attempts. Psychiatric/psychological followup visits may delay hospitalizations by closely monitoring symptoms of self-and hetero-aggression.

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Individualizing Treatment for Patients With Schizoaffective Disorder

Cited by 5 publications

References 18 publications

Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: a systematic review

Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: a systematic review

Psychosocial treatment and interventions for bipolar disorder: a systematic review

A 12-month prospective study on the time to hospitalization and clinical management of a cohort of bipolar type I and schizoaffective bipolar patients

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