The longitudinal course of schizoaffective disorders: A prospective follow-up study

To study whether outcome of schizoaffective psychosis is more similar to that of schizophrenia, or major affective disorders, or whether it shows an intermediate pattern between these two disorders, we conducted a prospective follow-up study of 167 patients from two hospitals. Thirty-nine schizoaffective patients, 47 schizophrenic patients, 33 manic patients, and 48 patients with major depressive disorders were assessed during hospitalization and then followed up 1 year after hospital discharge. Standardized assessments were conducted of patients' work functioning, social adjustment, symptom outcome, rehospitalization, treatment at follow-up, and their overall posthospital adjustment. The data indicated the following: A) On both major scales of overall outcome, schizoaffective patients' posthospital adjustment was significantly poorer than that of patients with major affective disorders (p <.01), and showed a nonsignificant tendency to be better than that of schizophrenics. Only 10 per cent of the schizoaffective patients had very favorable outcomes, b) There were no significant differences in overall outcome between schizoaffective patients who were manic us. depressed, or mainly affective vs. mainly schizophrenic (p >.20). c) Both the schizoaffective and affectively disordered patient groups had significantly better posthospital work functioning than did the schizophrenic patients (p <.05). d) However, both the schizoaffective and schizophrenic groups had significantly poorer post-hospital social functioning than did the affectively disordered patients (p <.05). Overall, the data suggest that outcome of schizoaffective disorders differs in some ways from that of both schizophrenia and affective disorders. The results indicate that a larger number of schizoaffective patients than patients with schizophrenia or affective disorders show intermediate outcomes, with both good posthospital functioning in some areas and poor posthospital functioning in other areas. These results do not support the currently popular suggestion that outcome of schizoaffective disorders is similar to that of affective disorders. Four potential models which use outcome in schizoaffective disorders as one criterion for diagnostic classification were discussed.