Long-term outcome of schizoaffective disorder. Are there any differences with respect to schizophrenia?

SUMMARY. Background. A number of studies suggest that the clinical characteristics and long-term outcome of schizoaffective patients close ly resemble those observed in schizophrenia when cases are diagnosed according to DSM criteria. The primary aim was to compare remission and recovery rates in a cohort of chronic schizoaffective and schizophrenic outpatients. Methods. A sample of 102 consecutive outpatients, 46 affect ed by schizophrenia (45.1%, mean age 44.22±9.97 years) and 66 affected by schizoaffective disorder (54.9%, mean age 43.00±9.07 years) was ex amined in the study. Personal data and psychiatric history were collected according to AMDP system; premorbid assessment was performed by means of PAS. Axis I and II psychiatric diagnosis was confirmed by means of SCID-I and II. Psychopathological status was evaluated by means of PANSS and CGI-SCH scales; neuropsychological evaluation was performed by means of BACS and MMSE; Functioning, subjective well-be ing and quality of life were respectively evaluated by means of PSP, SWN and WHOQoL-bref. Results. Schizophrenic and schizoaffective pa tients investigated were characterized by an overlapping age at onset, mean duration of illness, mean duration of untreated psychosis and com mon sociodemographic characteristics; subjects’ cross-sectional psychopathological and neurocognitive profiles were remarkably similar. Howev er, schizoaffective patients are more frequently of the female gender, showing a better social premorbid adjustment and a somewhat more com plicated clinical course in terms of more frequent hospitalizations and suicidality; outcome measures are substantially better among schizoaffec tive patients: rates of clinical remission were 43.5% and 54.5% in schizophrenic and schizoaffective patients, respectively; 13% and 25.8% of schiz ophrenic and schizoaffective patients, respectively, were considered as functionally remitted; recovery was observed in 6.5% and 22.7% of schiz ophrenic and schizoaffective patients, respectively; the majority of patients, both schizophrenic and schizoaffective, were taking antipsychotics, mainly atypical, although a significantly higher proportion of schizoaffective subjects were on mood stabilizers, antidepressants and benzodiazepines. Conclusion. Compared to schizophrenic patients, DSM-IV-TR schizoaffective patients may be considered as a subgroup of psychotic patients displaying several specific characteristics in terms of clinical course, clinical and functional outcome and treatment.