Schizoaffective disorder–an ongoing challenge for psychiatric nosology

Jäger, M.; Haack, S.; Becker, T.; Frasch, K.

doi:10.1016/j.eurpsy.2010.03.010

Cited by 98Schizophrenia research and treatmentBipolar Disorder and TreatmentMental Health and Psychiatry

Schizoaffective disorder–an ongoing challenge for psychiatric nosology

Jäger, M., Haack, S., Becker, T., Frasch, K.·2011·European Psychiatry

DOI 10.1016/j.eurpsy.2010.03.010

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Abstract

Objective: Schizoaffective disorder is a common diagnosis in mental health services. The present article aims to provide an overview of diagnostic reliability, symptomatology, outcome, neurobiology and treatment of schizoaffective disorder. Method: Literature was identified by searches in “Medline” and “Cochrane Library”. Results: The diagnosis of schizoaffective disorder has a low reliability. There are marked differences between the current diagnostic systems. With respect to psychopathological symptoms, no clear boundaries were found between schizophrenia, schizoaffective disorder and affective disorders. Common neurobiological factors were found across the traditional diagnostic categories. Schizoaffective disorder according to ICD-10 criteria, but not to DSM-IV criteria, shows a more favorable outcome than schizophrenia. With regard to treatment, only a small and heterogeneous database exists. Conclusion: Due to the low reliability and questionable validity there is a substantial need for revision and unification of the current diagnostic concepts of schizoaffective disorder. If future diagnostic systems return to Kraepelin's dichotomous classification of non-organic psychosis or adopt a dimensional diagnostic approach, schizoaffective disorder will disappear from the psychiatric nomenclature. A nosological model with multiple diagnostic entities, however, would be compatible with retaining the diagnostic category of schizoaffective disorder.

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Jager and colleagues reviewed six studies, found kappa values from 0.08 to 0.63, and concluded that only one study showed good agreement.
“Jager et al 47 reviewed six studies and reported kappa scores between 0.08 and 0.63, concluding that only one study showed good agreement.”
From The ICD‐11 developmental field study of reliability of diagnoses of high‐burden mental disorders: results among adult patients in mental health settings of 13 countries (2018) · cites this paper as [47]
The DSM has historically and currently used a longitudinal approach, and most earlier studies were based on it.
“This is different from the longitudinal approach historically and currently taken by the DSM, on which most previous studies have been based 46,47 .”
From The ICD‐11 developmental field study of reliability of diagnoses of high‐burden mental disorders: results among adult patients in mental health settings of 13 countries (2018) · cites this paper as [47]

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Authors: Jäger, M., Haack, S., Becker, T., & Frasch, K.
Affiliations: Universität Ulm (DE)
Corresponding author: Jäger, M.
ORCID: Jäger, M.
Haack, S.
Frasch, K.
Venue: European Psychiatry
Publisher: Cambridge University Press (CUP)
Published: 2011-04
Volume: 26
Issue: 3
Pages: 159-165
ISSN: 0924-9338 (ISSN-L)
1778-3585
DOI: 10.1016/j.eurpsy.2010.03.010
OpenAlex: W1966733434
Cited by: 98
References: 111
Citations by year: 2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 13 · 2018: 4 · 2017: 10 · 2016: 5 · 2015: 10 · 2014: 5 · 2013: 15 · 2012: 8
FWCI: 1.32
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified, 3303 d)
Locations: European Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: schizoaffective disorder, psychiatric classification, diagnostic reliability, diagnostic validity, schizophrenia, mood disorders, ICD-10 diagnostic criteria, DSM-IV diagnostic criteria, neurobiology, treatment, outcomes
MeSH terms: Diagnosis, Differential, Humans, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Reproducibility of Results, International Classification of Diseases

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Schizoaffective disorder–an ongoing challenge for psychiatric nosology

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