Schizoaffective Disorder???Its Rise and Fall: Perspectives for DSM-VAuthor(s): Charles Ray Lake , Nathaniel Hurwitz
Schizoaffective disorder, initiated in 1933, challenged the “Kraepelinian dichotomy” and Bleuler’s contention that psychosis defined schizophrenia. Schizoaffective disorder recognized the diagnostic importance of mood symptoms in psychotic patients. The concept of schizoaffective disorder linked schizophrenia and bipolar disorder, stimulating comparative studies that have revealed surprising similarities and overlap between patients diagnosed with schizophrenia versus bipolar disorder. Schizoaffective disorder has increased in popularity because it appears to cover both diagnoses in psychotic patients with symptoms of mania and/or depression. The popularity of schizoaffective disorder is reflected by a PubMed search that shows over a thousand articles per year citing schizoaffective disorder for the past three years. There has been a steady increase in articles since 1975 through the present. We have reviewed a recent, selected literature addressing the validity of schizoaffective disorder as well as that comparing schizophrenia and psychotic bipolar disorders. Overlap, especially from molecular genetic and neurocognitive studies, leads to the hypothesis that schizoaffective disorder is a psychotic mood disorder and not a separate disease. Implications for the Diagnostic and Statistical Manual of Mental Disorders-V are discussed.