Voluntary and involuntary admissions with schizoaffective disorder: do they differ from schizophrenia?
0
Citation
23
Reference
10
Related Paper
Abstract:
Schizoaffective disorder and schizophrenia are common presentations to psychiatry services. Research to date has focussed on hypothesised biological differences between these two disorders. Little is known about possible variations in admission patterns. Our study compared demographic and clinical features of patients admitted voluntarily and involuntarily with diagnoses of schizoaffective disorder or schizophrenia to three psychiatry admission units in Ireland.We studied all admissions to three acute psychiatry units in Ireland for periods between 1 January 2008 and 31 December 2018. We recorded demographic and clinical variables for all admissions. Voluntary and involuntary admissions of patients with schizoaffective disorder were compared to those with schizophrenia.We studied 5581 admissions to the study units for varying periods between January 2008 and December 2018, covering a total of 1 976 154 person-years across the 3 catchment areas. The 3 study areas had 218.8, 145.5 and 411.2 admissions per 100 000 person-years, respectively. Of the 5581 admissions over the study periods, schizoaffective disorder accounted for 5% (n = 260) and schizophrenia for 17% (n = 949). Admissions with schizoaffective disorder were significantly more likely to be female and older, and less likely to have involuntary admission status, compared to those with schizophrenia. As first admissions were not distinguished from re-admissions in this dataset, these findings merit further study.Admissions with a schizoaffective disorder differ significantly from those with schizophrenia, being, in particular, less likely to be involuntary admissions. This suggests that psychotic symptoms might be a stronger driver of involuntary psychiatry admission than affective symptoms.Forty-six habitual users of cannabis, who had been treated for psychosis during the years 1966-1970, were reported following an inquiry sent to Swedish psychiatric clinics and mental hospitals. Twenty-four of these cases had had psychotic episodes generally lasting 1-5 weeks, whereas 22 cases were running a chronic course. In 14 chronic cases an endogenous psychosis seemed to have been present before the drug debut. Seven of these showed a marked aggravation of the psychotic symptoms during periods of cannabis abuse. Eight cases of chronic psychosis occurred in earlier nonpsychotic subjects.Thirty cases occurred in formerly nonpsychotic individuals, though 23 of them had shown psychoneurotic traits. In seven of these, relapse into a second psychotic episode occurred following renewed cannabis abuse. The symptomatology reminded one of schizophrenic or manic-depressive endogenous psychoses in most instances, but confusional states were also seen. Evidence supporting the existence of a cannabis-induced psychosis has been discussed.
Effects of cannabis
Cite
Citations (66)
Diagnosis of schizophrenia
Cite
Citations (16)
Research Diagnostic Criteria
Diagnosis of schizophrenia
Cite
Citations (41)
Schizoaffective disorder is a disease with both affective and psychotic symptoms. In this study, we aimed to compare oxidative metabolism markers of schizoaffective disorder, bipolar disorder and schizophrenic patients. Furthermore, we also aimed to investigate whether schizoaffective disorder could be differentiated from schizophrenia and bipolar disorder in terms of oxidative metabolism.Total oxidant status (TOS) and total antioxidant status (TAS) were measured in the blood samples that were collected from schizoaffective patients (n = 30), bipolar disorder patients (n = 30) and schizophrenic patients (n = 30). Oxidative stress index (OSI) was calculated by dividing TOS by TAS.TOS and OSI were found to be higher in patients with schizoaffective disorder compared with those in schizophrenia and bipolar disorder patients. TAS was not significantly different between the groups.Schizoaffective disorder was found to be different from bipolar disorder and schizophrenia in terms of oxidative parameters. This result may indicate that schizoaffective disorder could differ from bipolar disorder and schizophrenia in terms of biochemical parameters. Increased TOS levels observed in schizoaffective disorder may suggest poor clinical course and may be an indicator of poor prognosis.
Cite
Citations (26)
The reduction of hippocampal volume was frequently reported in schizophrenia, but not in bipolar disorder This volume reduction is associated with clinical features of schizophrenia, in particular with working and verbal memory impairments. Schizoaffective disorder, as a specific disorder sharing clinical features of both schizophrenia and bipolar disorder is rarely analyzed as a separate disorder in neurobiological studies. The aim of this study was to compare hippocampal volumes in separate groups of patients with schizophrenia, schizoaffective and bipolar disorder. Hippocampal volumes were estimated using high resolution magnetic resonance imaging in 60 subjects, 15 subjects in each patient and one healthy volunteer (control) group. There were no significant differences in hippocampal volume between bipolar disorder and control group. Hippocampal volume was statistically significantly reduced in the group of patients with schizophrenia and schizoaffective disorder, compared to either bipolar disorder or control group, thus supporting the hypothesis that hippocampal volume reduction could be considered as a possible neurobiological basis for clinical aspects of schizophrenia and schizoaffective disorder associated with working and verbal memory impairment.
Cite
Citations (35)
Social functioning
Cite
Citations (0)
Schizoaffective disorder and schizophrenia are common presentations to psychiatry services. Research to date has focussed on hypothesised biological differences between these two disorders. Little is known about possible variations in admission patterns. Our study compared demographic and clinical features of patients admitted voluntarily and involuntarily with diagnoses of schizoaffective disorder or schizophrenia to three psychiatry admission units in Ireland.We studied all admissions to three acute psychiatry units in Ireland for periods between 1 January 2008 and 31 December 2018. We recorded demographic and clinical variables for all admissions. Voluntary and involuntary admissions of patients with schizoaffective disorder were compared to those with schizophrenia.We studied 5581 admissions to the study units for varying periods between January 2008 and December 2018, covering a total of 1 976 154 person-years across the 3 catchment areas. The 3 study areas had 218.8, 145.5 and 411.2 admissions per 100 000 person-years, respectively. Of the 5581 admissions over the study periods, schizoaffective disorder accounted for 5% (n = 260) and schizophrenia for 17% (n = 949). Admissions with schizoaffective disorder were significantly more likely to be female and older, and less likely to have involuntary admission status, compared to those with schizophrenia. As first admissions were not distinguished from re-admissions in this dataset, these findings merit further study.Admissions with a schizoaffective disorder differ significantly from those with schizophrenia, being, in particular, less likely to be involuntary admissions. This suggests that psychotic symptoms might be a stronger driver of involuntary psychiatry admission than affective symptoms.
Cite
Citations (0)
Diagnosis of schizophrenia
Cite
Citations (49)
Cite
Citations (25)
Back to table of contents Previous article Next article Clinical & Research NewsFull AccessIntellectual Status Differentiates Mental Illness RisksJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:3 Jan 2003https://doi.org/10.1176/pn.38.1.0020When it comes to intellectual, language, and behavioral performances, can adolescents who later develop bipolar disorder without psychosis be distinguished from adolescents who remain mentally healthy? The answer is no, a new study suggests.The study, in fact, appears to be the first that has ever assessed the intellectual, language, and behavioral capabilities of young people who will later be diagnosed with bipolar disorder without psychotic symptoms.The investigation was conducted by Michael Davidson, M.D., director of psychiatry at Chaim Sheba Medical Center in Tel-Hashomer, Israel, and colleagues and was reported in the December American Journal of Psychiatry.What the researchers did, essentially, was use prospective, although historical, data provided by both the Israeli Draft Board Registry and Israel’s National Psychiatric Hospitalization Case Registry for their study.First they focused on all adolescent Israelis who had been assessed by the draft board between 1985 and 1995. Then they zeroed in only on those adolescents who had no history of psychiatric illness and no sign of psychiatric illness at the time they were assessed by the draft board. Then they used the psychiatric hospitalization registry to determine which of these adolescents were subsequently hospitalized for schizophrenia, schizoaffective disorder, or nonpsychotic bipolar disorder. A total of 536 had been hospitalized for schizophrenia; 31 for schizoaffective disorder, and 68 for nonpsychotic bipolar disorder. On average, they had been hospitalized for these conditions when they were 20 or 21 years of age.The investigators then matched each of these 635 subjects with an Israeli who had been assessed by the draft board at the same age, who had attended the same high school, and who did not appear in the psychiatric hospitalization registry during the follow-up period.The scientists then compared draft board data about the intellectual, language, and behavioral abilities of the 635 subjects with draft board data about the intellectual, language, and behavioral abilities of the 635 controls. This way, they reasoned, they could determine how the mental and behavioral capabilities of the young people who later developed schizophrenia, schizoaffective disorder, or nonpsychotic bipolar disorder compared with the mental and behavioral capabilities of the young people who entered adulthood in good mental health.The subjects who later developed schizophrenia had been significantly impaired on all intellectual aptitudes tested. These included verbal intelligence; verbal abstraction and categorization; mathematical reasoning, concentration, and concept manipulation; and nonverbal abstract reasoning and visual-spatial problem-solving abilities. In contrast, subjects who later developed schizoaffective disorder had been significantly impaired on only one of the intellectual proficiencies tested—nonverbal abstract reasoning and visual-spatial problem solving. Subjects who later developed bipolar disorder had not been significantly impaired on any of the intellectual skills that were assessed.The subjects who later developed schizophrenia had been significantly impaired on reading ability and on reading comprehension, but not on writing ability. (In fact, their writing ability was significantly better than that of controls—a finding for which the investigators have no explanation, Davidson told Psychiatric News. ) In contrast, neither the subjects who eventually developed schizoaffective disorder nor those who eventually developed bipolar disorder had been significantly disabled in these language areas.Regarding the behavioral competencies scrutinized—for example, the ability to function socially, organize one’s life, or function at work or school—subjects who later developed schizophrenia had been handicapped on all of them. In contrast, subjects who later developed schizoaffective disorder displayed deficits in all of these proficiencies but one, yet none of the differences reached statistical significance. Subjects who subsequently developed bipolar disorder performed similarly to controls on all behavioral abilities tested.Taking all the results together, it appears that young people destined for bipolar disorder without psychosis do not differ from mentally healthy young people as far as intellectual, language, or behavioral capabilities are concerned; however, those adolescents who will eventually develop schizophrenia do. And those young people who eventually acquire schizoaffective disorder appear to lie in the middle—not quite at the same level as controls, but certainly better than those individuals who eventually develop schizophrenia.Kenneth Davis, M.D., chair of psychiatry at Mount Sinai Hospital in New York City, is familiar with this study by Davidson and his team. As he told Psychiatric News, its “findings, coming from a population-based cohort, further support the nosologic distinction between schizophrenia and nonpsychotic bipolar disorder.”The study, “A Population-Based Cohort Study of Premorbid Intellectual, Language, and Behavioral Functioning in Patients With Schizophrenia, Schizoaffective Disorder, and Nonpsychotic Bipolar Disorder,” is posted on the Web at http://ajp.psychiatryonline.org/cgi/content/full/159/12/2027?. ▪ Am J Psychiatry 2002 159 2027 ISSUES NewArchived
Cite
Citations (0)