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Exploring the borders of the schizoaffective spectrum: a categorical and dimensional approach.
J Affect Disord. 2008 May; 108(1-2):71-86.JA

Abstract

BACKGROUND

Schizoaffective disorder has long been considered as an intermediate condition between major mood disorders and schizophrenia, however, the nature of the relationship to these diagnoses remains unclear. We aimed at examining the nature of such a relationship in a mixed sample of psychotic disorders by using a dimensional and categorical approach to psychopathology.

METHODS

Six-hundred and sixty psychotic inpatients were assessed for lifetime ratings of mania, depression, psychosis and incongruence, diagnosed according to Research Diagnostic Criteria, and classified as having nonaffective psychosis without mood syndromes (n=429), nonaffective psychosis with mood syndromes (n=101), schizoaffective disorder mainly schizophrenic (n=41), schizoaffective disorder mainly affective (n=42) or mood disorder with psychotic symptoms (n=47). We tested for associations of illness-related features including risk factors, premorbid, clinical and outcome variables with classes of disorders and lifetime ratings of psychopathology, and examined the relative contribution of categorical and dimensional representations of psychopathology in explaining disease characteristics.

RESULTS

While categories at the extreme end of the psychotic spectrum meaningfully differed across a number of the illness-related variables, no substantial discontinuity was apparent between adjacent categories of psychotic disorders. Risk factors, premorbid adjustment, clinical features and impairment appeared to be present in a mostly monotonic continuous fashion from nonaffective psychoses to mood disorders with psychotic features. The overall association pattern of illness-related variables with mood and psychotic syndromes was largely independent of specific diagnostic categories, and the dimensional approach was neatly superior to the traditional diagnostic approach in explaining the characteristics of the illness.

LIMITATIONS

This was a cross-sectional study with retrospective assessment of illness-related-variables and lifetime psychopathology.

CONCLUSION

The results are compatible with the notion of the schizoaffective spectrum and with a continuum model of the psychotic illness.

Authors+Show Affiliations

Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain. victor.peralta.martin@cfnavarra.esNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18029027

Citation

Peralta, Victor, and Manuel J. Cuesta. "Exploring the Borders of the Schizoaffective Spectrum: a Categorical and Dimensional Approach." Journal of Affective Disorders, vol. 108, no. 1-2, 2008, pp. 71-86.
Peralta V, Cuesta MJ. Exploring the borders of the schizoaffective spectrum: a categorical and dimensional approach. J Affect Disord. 2008;108(1-2):71-86.
Peralta, V., & Cuesta, M. J. (2008). Exploring the borders of the schizoaffective spectrum: a categorical and dimensional approach. Journal of Affective Disorders, 108(1-2), 71-86.
Peralta V, Cuesta MJ. Exploring the Borders of the Schizoaffective Spectrum: a Categorical and Dimensional Approach. J Affect Disord. 2008;108(1-2):71-86. PubMed PMID: 18029027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exploring the borders of the schizoaffective spectrum: a categorical and dimensional approach. AU - Peralta,Victor, AU - Cuesta,Manuel J, Y1 - 2007/10/29/ PY - 2007/08/06/received PY - 2007/09/21/revised PY - 2007/09/22/accepted PY - 2007/11/22/pubmed PY - 2008/6/6/medline PY - 2007/11/22/entrez SP - 71 EP - 86 JF - Journal of affective disorders JO - J Affect Disord VL - 108 IS - 1-2 N2 - BACKGROUND: Schizoaffective disorder has long been considered as an intermediate condition between major mood disorders and schizophrenia, however, the nature of the relationship to these diagnoses remains unclear. We aimed at examining the nature of such a relationship in a mixed sample of psychotic disorders by using a dimensional and categorical approach to psychopathology. METHODS: Six-hundred and sixty psychotic inpatients were assessed for lifetime ratings of mania, depression, psychosis and incongruence, diagnosed according to Research Diagnostic Criteria, and classified as having nonaffective psychosis without mood syndromes (n=429), nonaffective psychosis with mood syndromes (n=101), schizoaffective disorder mainly schizophrenic (n=41), schizoaffective disorder mainly affective (n=42) or mood disorder with psychotic symptoms (n=47). We tested for associations of illness-related features including risk factors, premorbid, clinical and outcome variables with classes of disorders and lifetime ratings of psychopathology, and examined the relative contribution of categorical and dimensional representations of psychopathology in explaining disease characteristics. RESULTS: While categories at the extreme end of the psychotic spectrum meaningfully differed across a number of the illness-related variables, no substantial discontinuity was apparent between adjacent categories of psychotic disorders. Risk factors, premorbid adjustment, clinical features and impairment appeared to be present in a mostly monotonic continuous fashion from nonaffective psychoses to mood disorders with psychotic features. The overall association pattern of illness-related variables with mood and psychotic syndromes was largely independent of specific diagnostic categories, and the dimensional approach was neatly superior to the traditional diagnostic approach in explaining the characteristics of the illness. LIMITATIONS: This was a cross-sectional study with retrospective assessment of illness-related-variables and lifetime psychopathology. CONCLUSION: The results are compatible with the notion of the schizoaffective spectrum and with a continuum model of the psychotic illness. SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/18029027/Exploring_the_borders_of_the_schizoaffective_spectrum:_a_categorical_and_dimensional_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(07)00337-0 DB - PRIME DP - Unbound Medicine ER -