Review

Heterogeneity of schizoaffective disorder compared with schizophrenia and bipolar disorder

  1. T. Pagel1,
  2. R. J. Baldessarini2,
  3. J. Franklin3,
  4. C. Baethge1,*

Article first published online: 7 MAR 2013

DOI: 10.1111/acps.12109

Additional Information

How to Cite

Pagel T, Baldessarini RJ, Franklin J, Baethge C. Heterogeneity of schizoaffective disorder compared with schizophrenia and bipolar disorder.

Author Information

  1. 1

    Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany

  2. 2

    Department of Psychiatry, Harvard Medical School, Boston, MA, USA

  3. 3

    Institute of Medical Statistics, Informatics, and Epidemiology, University of Cologne Medical School, Cologne, Germany

* Christopher Baethge, Klinik für Psychiatrie und Psychotherapie, Universität zu Köln, Kerpener Str. 62, 50937 Köln, Germany.
E-mail: cbaethge@uni-koeln.de

Publication History

  1. Article first published online: 7 MAR 2013
  2. Manuscript Accepted: 30 JAN 2013

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Keywords:

  • Bipolar Disorder;
  • Nosology;
  • Schizophrenia;
  • Biostatistics;
  • Psychopathology

Objective

Low diagnostic reliability, the need to meet criteria of two disorders, and its status as residual diagnosis in clinical practice led us to hypothesize that schizoaffective disorder (SAD) is characterized by considerable heterogeneity, particularly in comparison with schizophrenia (SZ) and bipolar disorder (BD). As this has not been investigated the aim of this study is to test whether heterogeneity is larger in SAD than in SZ and BD.

Method

Systematic search for studies simultaneously comparing all three diagnoses regarding demographic, clinical, psychometric (clinical rating scales and IQ tests), and biological parameters; comparison of heterogeneity as measured by standard deviation (SD).

Results

Standard deviation of SAD samples (N = 47) was smaller than in both differential diagnoses. SDs were 7% higher in BD than in SAD (SZ: 2% higher); in studies employing DSM-IIIR/–IV pooled SD was 4% higher in BD (8% lower in SZ). Differences between diagnoses were limited to the comparison of SAD and BD, and became smaller when only psychotic BD was considered.

Conclusion

Heterogeneity of SZ and BD is not smaller than that of SAD. SAD seems not to be more diverse than other functional psychoses. Results are preliminary because of the novelty of the approach and to the small number of studies.

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