Am J Psychiatry 1991; 148:1359-1365
Copyright © 1991 by American Psychiatric Association
Outcome of schizoaffective disorder at two long-term follow-ups: comparisons with outcome of schizophrenia and affective disorders
LS Grossman, M Harrow, JF Goldberg and CG Fichtner
Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL.
OBJECTIVE: This research assessed whether the outcome of schizoaffective
disorder is more similar to that of schizophrenia or that of affective
disorders. METHOD: The authors conducted a prospective follow-up study of
101 schizoaffective, schizophrenic, bipolar manic, and depressed patients
assessed at three times: during hospitalization and 2 and 4-5 years later.
The follow-up test battery involved detailed assessment of social
functioning, work performance, symptoms, posthospital treatment, and
rehospitalization. RESULTS: Outcome for schizoaffective patients 4-5 years
after hospitalization differed significantly from that for patients with
unipolar depression. However, the differences between schizoaffective and
bipolar manic patients were more equivocal. Unlike the patients with
bipolar disorder, only a limited number of patients with schizoaffective
disorder showed complete recovery in all areas throughout the year
preceding the 2-year follow-up and the year preceding the 4- to 5-year
follow-up. The differences in outcome between schizoaffective and
schizophrenic patients were also mixed. These two groups showed some
similarities in outcome, but there were fewer schizoaffective than
schizophrenic patients with uniformly poor outcome in all areas.
CONCLUSIONS: Overall, schizoaffective patients showed some similarities to
both schizophrenic and bipolar manic patients. Schizoaffective patients had
somewhat better overall posthospital functioning than patients with
schizophrenia, somewhat poorer functioning than bipolar manic patients, and
significantly poorer functioning than patients with unipolar depression.
The data suggest that when mood-incongruent, schizophrenic-like psychotic
symptoms are present in the acute phase, they predict considerable
difficulty in outcome, even when affective syndromes are also present, as
in schizoaffective disorder. It is likely that schizoaffective disorder is
not just a simple variety of affective disorder.
