Differences between first episode schizophrenia and schizoaffective disorder
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Differences between first episode schizophrenia and schizoaffective disorder. / Cotton, S M; Lambert, M; Schimmelmann, B G; Mackinnon, A; Gleeson, J F M; Berk, M; Hides, L; Chanen, A M; Scott, J; Schöttle, D; McGorry, P D; Conus, P.
In: SCHIZOPHR RES, Vol. 147, No. 1, 01.06.2013, p. 169-74.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Differences between first episode schizophrenia and schizoaffective disorder
AU - Cotton, S M
AU - Lambert, M
AU - Schimmelmann, B G
AU - Mackinnon, A
AU - Gleeson, J F M
AU - Berk, M
AU - Hides, L
AU - Chanen, A M
AU - Scott, J
AU - Schöttle, D
AU - McGorry, P D
AU - Conus, P
N1 - Copyright © 2013 Elsevier B.V. All rights reserved.
PY - 2013/6/1
Y1 - 2013/6/1
N2 - BACKGROUND: The diagnostic and clinical overlap between schizophrenia and schizoaffective disorder is an important nosological issue in psychiatry that is yet to be resolved. The aim of this study was to compare the clinical and functional characteristics of an epidemiological treated cohort of first episode patients with an 18-month discharge diagnosis of schizophrenia (FES) or schizoaffective disorder (FESA).METHODS: This study was part of the larger First Episode Psychosis Outcome Study (FEPOS) which involved a medical file audit study of all 786 patients treated at the Early Psychosis Prevention and Intervention Centre between 1998 and 2000. Of this cohort, 283 patients had an 18-month discharge diagnosis of FES and 64 had a diagnosis of FESA. DSM-IV diagnoses and clinical and functional ratings were derived and validated by two consultant psychiatrists.RESULTS: Compared to FES patients, those with FESA were significantly more likely to have a later age of onset (p=.004), longer prodrome (p=.020), and a longer duration of untreated psychosis (p<.001). At service entry, FESA patients presented with a higher illness severity (p=.020), largely due to the presence of more severe manic symptoms (p<.001). FESA patients also had a greater number of subsequent inpatient admissions (p=.017), had more severe depressive symptoms (p=.011), and higher levels of functioning at discharge.DISCUSSION: The findings support the notion that these might be considered two discernable disorders; however, further research is required to ascertain the ways and extent to which these disorders are discriminable at presentation and over time.
AB - BACKGROUND: The diagnostic and clinical overlap between schizophrenia and schizoaffective disorder is an important nosological issue in psychiatry that is yet to be resolved. The aim of this study was to compare the clinical and functional characteristics of an epidemiological treated cohort of first episode patients with an 18-month discharge diagnosis of schizophrenia (FES) or schizoaffective disorder (FESA).METHODS: This study was part of the larger First Episode Psychosis Outcome Study (FEPOS) which involved a medical file audit study of all 786 patients treated at the Early Psychosis Prevention and Intervention Centre between 1998 and 2000. Of this cohort, 283 patients had an 18-month discharge diagnosis of FES and 64 had a diagnosis of FESA. DSM-IV diagnoses and clinical and functional ratings were derived and validated by two consultant psychiatrists.RESULTS: Compared to FES patients, those with FESA were significantly more likely to have a later age of onset (p=.004), longer prodrome (p=.020), and a longer duration of untreated psychosis (p<.001). At service entry, FESA patients presented with a higher illness severity (p=.020), largely due to the presence of more severe manic symptoms (p<.001). FESA patients also had a greater number of subsequent inpatient admissions (p=.017), had more severe depressive symptoms (p=.011), and higher levels of functioning at discharge.DISCUSSION: The findings support the notion that these might be considered two discernable disorders; however, further research is required to ascertain the ways and extent to which these disorders are discriminable at presentation and over time.
KW - Adolescent
KW - Adult
KW - Cohort Studies
KW - Female
KW - Humans
KW - Male
KW - Outcome Assessment (Health Care)
KW - Psychiatric Status Rating Scales
KW - Psychotic Disorders
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Schizophrenia
KW - Severity of Illness Index
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1016/j.schres.2013.02.036
DO - 10.1016/j.schres.2013.02.036
M3 - SCORING: Journal article
C2 - 23528796
VL - 147
SP - 169
EP - 174
JO - SCHIZOPHR RES
JF - SCHIZOPHR RES
SN - 0920-9964
IS - 1
ER -