Stability of Schizoaffective Disorder in Correlation with Duration of Follow-Up: Retrospective Analysis
Stability of Schizoaffective Disorder in Correlation with Duration of Follow-Up: Retrospective Analysis
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DOI：
10.1159/000318812
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发表时间：
2010-01-01
期刊：
影响因子：
3.6
通讯作者：
Fischel, Tsvi
中科院分区：
文献类型：
--
作者：
Brenner, Inbal;Krivoy, Amir;Fischel, Tsvi
背景/目的：以往的研究表明，根据DSM-IV标准诊断情感性精神障碍（SAD）的效度和信度不足，且诊断的稳定性较差。然而，没有研究专门检查SAD的诊断稳定性。本研究的目的是在大样本患者中检查SAD和SAD亚型诊断的纵向稳定性，并检查人口统计学和临床变量作为诊断稳定性的预测因素。研究方法：对2000年至2005年期间在Geha精神卫生中心住院的123名住院患者进行了回顾性图表审查，这些患者在疾病的某个阶段被诊断为SAD。我们比较了SAD诊断保持稳定的患者组和诊断发生变化的患者组。结果：SAD诊断稳定性为73.1%。诊断转换主要是从精神分裂症和向精神分裂症。我们发现SAD双相亚型与较高的诊断稳定率之间存在关联。诊断稳定的患者组自SAD诊断以来的时间显著短于诊断改变的患者组（p = 0.037）。结论：SAD的诊断稳定性可能高于以往报道。被诊断为SAD躁狂亚型的患者比其他SAD亚型的患者更倾向于保留诊断。诊断变化来自疾病过程中新症状的表现。澄清目前的诊断标准，以便能够更准确地利用SAD亚型诊断是必要的。研究局限性：（a）研究设计是回顾性的，需要进一步的前瞻性研究来确定我们的发现;（B）SAD亚型定义存在误用，因此关于SAD极性和诊断稳定性的结论是有限的;（c）研究人群由住院患者组成，因此推广到门诊人群应谨慎。版权所有（C）2010 S. Karger AG，巴塞尔
Background/Aims: Previous studies have indicated that the validity and reliability of schizoaffective disorder (SAD) diagnosis according to the DSM-IV criteria are insufficient, and that the stability of the diagnosis is poor. However, no study has examined exclusively the diagnostic stability of SAD. The aims of this study were to examine the longitudinal stability of the diagnosis of SAD and SAD subtypes among a large sample of patients, and to examine demographic and clinical variables as predictors of diagnostic stability. Methods: A retrospective chart review of 123 inpatients who were admitted to Geha Mental Health Center between the years 2000 and 2005, and who had been diagnosed with SAD at some stage of their illness. We compared the group of patients whose diagnosis of SAD had remained stable and the group of patients whose diagnosis had changed. Results: The diagnostic stability for SAD was 73.1%. Diagnostic transitions were mainly from and towards schizophrenia. We found an association between the SAD bipolar subtype and higher rates of diagnostic stability. The time that had elapsed since SAD diagnosis was made was significantly shorter in the group of patients with stable diagnosis than in the group of patients whose diagnosis had changed (p = 0.037). Conclusions: The diagnostic stability of SAD might be higher than previously reported. Patients who are diagnosed with SAD manic subtype have a higher tendency to retain their diagnosis than patients with other SAD subtypes. The diagnostic changes are derived from manifestations of new symptoms in the course of the disease. Clarification of the current diagnostic criteria in order to enable a more precise utilization of the SAD subtype diagnoses is warranted. Study Limitations: (a) The study design was retrospective and further prospective studies are needed to establish our findings; (b) there is a misusage of the SAD subtype definitions, thus conclusions regarding polarity of SAD and stability of diagnosis are limited, and (c) the population studied was comprised of inpatients, therefore generalization to the outpatient population should be done with caution. Copyright (C) 2010 S. Karger AG, Basel