Am J Psychiatry 1992; 149:1666-1673
Copyright © 1992 by American Psychiatric Association
Schizoaffective disorder and affective disorders with mood-incongruent psychotic features: keep separate or combine? Evidence from a family study
W Maier, D Lichtermann, J Minges, R Heun, J Hallmayer and O Benkert
Department of Psychiatry, University of Mainz, Germany.
OBJECTIVE: This study investigated whether the distinction between
schizoaffective disorder and affective disorders with mood-incongruent
psychotic features as described in DSM-III-R is reflected by aggregation of
schizophrenia in the families of probands with the former disorder and
aggregation of affective disorders mainly among the relatives of probands
with the latter type of disorders. METHOD: The probands were 118 inpatients
with definite lifetime diagnoses of DSM- III-R schizoaffective disorder or
a major mood disorder with incongruent psychotic features according to
structured clinical interviews. Diagnostic information on 475 of the
probands' first-degree relatives was gathered through direct interviews
(with 80% of the living first-degree relatives) or the family history
approach. The rates of affective and psychotic disorders among these
relatives were then compared with those among the relatives of a comparison
group of 109 interviewed individuals from the general population who were
matched on sociodemographic factors to the inpatient probands. RESULTS:
With regard to the familial aggregation of schizophrenia, the DSM-III-R
distinction emerged as valid. However, the risk of unipolar affective
disorders was enhanced in the families of all of the subgroups of patients
studied. The unipolar/bipolar distinction in both DSM-III-R diagnostic
groups was reflected by distinct patterns of bipolar disorders in the
relatives. CONCLUSIONS: The results partly support the DSM-III-R dichotomy
of schizoaffective disorder and affective disorders with mood-incongruent
psychotic features. Although the differences between these two diagnostic
groups were significant, the magnitude of the differences remained
relatively modest.
