The modern concept of schizoaffective disorder: a narrative review

BACKGROUND: Schizoaffective disorder (SAD) is one of the most complex and controversial diagnoses in clinical psychiatry. Despite the significant changes that have occurred in the conceptualization of SAD in modern classifications and the publications of recent years, many unresolved issues remain r...

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Main Authors: Aleksey V. Pavlichenko, Natalia N. Petrova, Andrey R. Stolyarov
Format: Article
Language:English
Published: Eco-Vector 2024-10-01
Series:Consortium Psychiatricum
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Online Access:https://consortium-psy.com/jour/article/viewFile/15513/pdf
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author Aleksey V. Pavlichenko
Natalia N. Petrova
Andrey R. Stolyarov
author_facet Aleksey V. Pavlichenko
Natalia N. Petrova
Andrey R. Stolyarov
author_sort Aleksey V. Pavlichenko
collection DOAJ
description BACKGROUND: Schizoaffective disorder (SAD) is one of the most complex and controversial diagnoses in clinical psychiatry. Despite the significant changes that have occurred in the conceptualization of SAD in modern classifications and the publications of recent years, many unresolved issues remain regarding the disease, from the point of view of clinical psychiatry and basic neuroscience. AIM: The purpose of this paper is to summarize published data on the concept of SAD, its clinical characteristics, cognitive profile, potential biomarkers, as well as the place of the disease in the following modern international classifications: the International Classification of Diseases (ICD) 9th, 10th and 11th revisions, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). METHODS: We undertook a review of the scientific studies in the relevant bibliographic systems and databases (eLIBRARY, PubMed) of the past 15 years. The descriptive analysis method was used to summarize the collected information. A total of 70 publications were selected for review, including different versions of international classifications of diseases (ICD and DSM-5). RESULTS: There has been some improvement in the inter-rater reliability of SAD criteria in modern classifications, but this has not yet led to a clearer understanding among mental health specialists, while the various subtypes of SAD identified so far fail to account for the heterogeneity in the clinical presentation of the disorder. The dimensional approach to diagnosing SAD, according to which the intensity of psychotic and affective symptoms can fluctuate over time and they can influence one another, more accurately reflects the disease’s ability to embody different forms. Basic research does not support the identification of a distinct cognitive, neuroimaging, or immunological SAD endophenotype that differs qualitatively from schizophrenia and affective psychoses. CONCLUSION: The conceptualization of SAD remains incomplete, and new approaches rooted in neuroscience are needed to better understand the coexistence of affective and psychotic symptoms.
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spelling doaj-art-f28f0e67692945d6abaa0b5c11cc5ad42024-12-07T06:28:37ZengEco-VectorConsortium Psychiatricum2712-76722713-29192024-10-0153425510.17816/CP15513156The modern concept of schizoaffective disorder: a narrative reviewAleksey V. Pavlichenko0https://orcid.org/0000-0003-2742-552XNatalia N. Petrova1https://orcid.org/0000-0003-4096-6208Andrey R. Stolyarov2https://orcid.org/0000-0002-2274-0734Lomonosov Moscow State UniversitySaint Petersburg State UniversitySaint Petersburg State UniversityBACKGROUND: Schizoaffective disorder (SAD) is one of the most complex and controversial diagnoses in clinical psychiatry. Despite the significant changes that have occurred in the conceptualization of SAD in modern classifications and the publications of recent years, many unresolved issues remain regarding the disease, from the point of view of clinical psychiatry and basic neuroscience. AIM: The purpose of this paper is to summarize published data on the concept of SAD, its clinical characteristics, cognitive profile, potential biomarkers, as well as the place of the disease in the following modern international classifications: the International Classification of Diseases (ICD) 9th, 10th and 11th revisions, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). METHODS: We undertook a review of the scientific studies in the relevant bibliographic systems and databases (eLIBRARY, PubMed) of the past 15 years. The descriptive analysis method was used to summarize the collected information. A total of 70 publications were selected for review, including different versions of international classifications of diseases (ICD and DSM-5). RESULTS: There has been some improvement in the inter-rater reliability of SAD criteria in modern classifications, but this has not yet led to a clearer understanding among mental health specialists, while the various subtypes of SAD identified so far fail to account for the heterogeneity in the clinical presentation of the disorder. The dimensional approach to diagnosing SAD, according to which the intensity of psychotic and affective symptoms can fluctuate over time and they can influence one another, more accurately reflects the disease’s ability to embody different forms. Basic research does not support the identification of a distinct cognitive, neuroimaging, or immunological SAD endophenotype that differs qualitatively from schizophrenia and affective psychoses. CONCLUSION: The conceptualization of SAD remains incomplete, and new approaches rooted in neuroscience are needed to better understand the coexistence of affective and psychotic symptoms.https://consortium-psy.com/jour/article/viewFile/15513/pdfschizoaffective disordericd-9icd-10icd-11dsm-5biomarkerscognitive functioning
spellingShingle Aleksey V. Pavlichenko
Natalia N. Petrova
Andrey R. Stolyarov
The modern concept of schizoaffective disorder: a narrative review
Consortium Psychiatricum
schizoaffective disorder
icd-9
icd-10
icd-11
dsm-5
biomarkers
cognitive functioning
title The modern concept of schizoaffective disorder: a narrative review
title_full The modern concept of schizoaffective disorder: a narrative review
title_fullStr The modern concept of schizoaffective disorder: a narrative review
title_full_unstemmed The modern concept of schizoaffective disorder: a narrative review
title_short The modern concept of schizoaffective disorder: a narrative review
title_sort modern concept of schizoaffective disorder a narrative review
topic schizoaffective disorder
icd-9
icd-10
icd-11
dsm-5
biomarkers
cognitive functioning
url https://consortium-psy.com/jour/article/viewFile/15513/pdf
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