Schizoaffective disorder-- the reliability of its clinical diagnostic use

Acta Psychiatr Scand. 2006 May;113(5):402-7. doi: 10.1111/j.1600-0447.2005.00744.x.

Abstract

Objective: Patients with psychoses often suffer from affective symptoms. The originally broad concept of schizoaffective disorder (SAD) has been significantly narrowed, transformed into a convoluted set of criteria both in the ICD-10 and DSM-IV. We examined the reliability of the clinical use of this diagnosis in university settings.

Method: All patients discharged from two university hospitals in Copenhagen in year 2002 with a diagnosis of ICD-10 SAD (n = 59) were re-evaluated using the Operational Criteria (OPCRIT) checklist expanded by additional items and applied to hospital chart material. Diagnoses were allocated by OPCRIT algorithm and by consensus of two psychiatrists.

Results: No patients fulfilled the SAD lifetime diagnosis according to DSM-IV criteria and the raters diagnosed only six patients as possible ICD-10 SAD.

Conclusion: A moratorium on the clinical use of the SAD diagnosis is suggested.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Databases as Topic
  • Denmark
  • Diagnostic Errors / psychology
  • Diagnostic Errors / statistics & numerical data
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Hospitals, University / statistics & numerical data
  • Humans
  • International Classification of Diseases / statistics & numerical data
  • Male
  • Middle Aged
  • Psychiatric Department, Hospital / statistics & numerical data
  • Psychotic Disorders / classification
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology
  • Reproducibility of Results