Exploring the borders of the schizoaffective spectrum: A categorical and dimensional approach
Exploring the borders of the schizoaffective spectrum: A categorical and dimensional approach
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DOI：
10.1016/j.jad.2007.09.009
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发表时间：
2008-05-01
影响因子：
6.6
通讯作者：
Cuesta, Manuel J.
中科院分区：
文献类型：
--
作者：
Peralta, Victor;Cuesta, Manuel J.
背景资料：长期以来，分裂情感性障碍一直被认为是主要心境障碍和精神分裂症之间的中间状态，然而，与这些诊断的关系的性质仍然不清楚。我们的目的是通过使用精神病理学的维度和分类方法来检查精神障碍混合样本中这种关系的性质。对660例住院精神病患者进行了躁狂、抑郁、精神病和不协调的终身评定，根据研究诊断标准进行诊断，并将其归类为无情绪综合征的非情感性精神病（n = 429），非情感性精神病伴心境综合征101例，以精神分裂症为主的情感性精神障碍41例，以情感性精神障碍为主的情感性精神障碍42例，以精神病性症状为主的心境障碍47例。我们检验了疾病相关特征的相关性，包括危险因素、发病前、临床和结果变量与疾病类别和精神病理学终身评级的相关性，并检验了精神病理学的分类和维度表征在解释疾病特征方面的相对贡献。虽然精神病谱系的极端类别在许多疾病相关变量中存在有意义的差异，在相邻的精神障碍类别之间没有明显的实质性中断。从非情感性精神病到具有精神病特征的心境障碍，危险因素、病前调整、临床特征和损害似乎以大多单调连续的方式存在。疾病相关变量与情绪和精神病综合征的整体关联模式在很大程度上独立于特定的诊断类别，维度方法在解释疾病特征方面明显优于传统的诊断方法。局限性：这是一项回顾性评估疾病相关变量和终身精神病理学的横断面研究。结果是兼容的概念的情感频谱和连续模型的精神病。(C)2007 Elsevier B.V.保留所有权利。
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. (C) 2007 Elsevier B.V. All rights reserved.