Empirical support for DSM-IV schizoaffective disorder: clinical and cognitive validators from a large patient sample.
Empirical support for DSM-IV schizoaffective disorder: clinical and cognitive validators from a large patient sample.
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DOI：
10.1371/journal.pone.0063734
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Malhotra AK
中科院分区：
文献类型：
--
作者：
DeRosse P;Burdick KE;Lencz T;Siris SG;Malhotra AK
精神分裂情感性障碍的诊断在精神病学中长期处于不确定的地位。比较分裂情感性障碍患者与相关疾病（如精神分裂症和双相情感障碍）患者的临床和生物学特征的研究可以为判断诊断类别的有效性提供证据基础。然而，由于大多数先前的分裂情感性障碍研究只在一个静态的时间点上评估了群体之间的差异，当考虑到整个疾病过程时，这些障碍如何相关尚不清楚。我们确定了一个大队列[N = 993]精神病患者的一系列精神病诊断，包括精神分裂症，没有重大情感发作史[SZ−；N = 371]，精神分裂症合并叠加性情绪综合征[SZ+；N = 224]，分裂情感性障碍[SAD；N = 129]和伴有精神病性特征的双相I型障碍[BPD+；n = 269]。使用横断面数据，我们设计了关键的临床和神经认知依赖测量，使我们能够测试这些诊断实体之间差异的纵向假设。在几个人口学和临床变量的诊断组之间观察到很大的差异。最值得注意的是，各组在认知能力下降的假定衡量标准上存在差异。具体来说，与BP+组相比，SAD组表现出更大的发病后认知能力下降，SZ -和SZ+组均表现出中度至BPD+和SAD的下降水平。这些结果表明，分裂情感障碍可能具有明显的特征。与早期的表述相反，精神分裂情感障碍可能是一种更严重的疾病。
The diagnosis of schizoaffective disorder has long maintained an uncertain status in psychiatric nosology. Studies comparing clinical and biological features of patients with schizoaffective disorder to patients with related disorders [e.g., schizophrenia and bipolar disorder] can provide an evidence base for judging the validity of the diagnostic category. However, because most prior studies of schizoaffective disorder have only evaluated differences between groups at a static timepoint, it is unclear how these disorders may be related when the entire illness course is taken into consideration. We ascertained a large cohort [N = 993] of psychiatric patients with a range of psychotic diagnoses including schizophrenia with no history of major affective episodes [SZ−; N = 371], schizophrenia with a superimposed mood syndrome [SZ+; N = 224], schizoaffective disorder [SAD; N = 129] and bipolar I disorder with psychotic features [BPD+; N = 269]. Using cross-sectional data we designed key clinical and neurocognitive dependent measures that allowed us to test longitudinal hypotheses about the differences between these diagnostic entities. Large differences between diagnostic groups on several demographic and clinical variables were observed. Most notably, groups differed on a putative measure of cognitive decline. Specifically, the SAD group demonstrated significantly greater post-onset cognitive decline compared to the BP+ group, with the SZ− and SZ+ group both exhibiting levels of decline intermediate to BPD+ and SAD. These results suggest that schizoaffective disorder may possess distinct features. Contrary to earlier formulations, schizoaffective disorder may be a more severe form of illness.
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影响因子：
--
作者：
Reichenberg, A;Weiser, M;Davidson, M
通讯作者：
Davidson, M
影响因子：
6.6
作者：
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通讯作者：
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影响因子：
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作者：
DeRosse P;Lencz T;Burdick KE;Siris SG;Kane JM;Malhotra AK
通讯作者：
Malhotra AK
影响因子：
5.3
作者：
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通讯作者：
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影响因子：
17.7
作者：
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通讯作者：
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