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Abstract
Difficulties surrounding the classification of mixed psychotic and mood symptoms continue to plague psychiatric nosology. Since schizoaffective disorder was first defined in the literature, it has raised a considerable controversy regarding its clinical distinction from schizophrenia and mood disorder, especially mood disorder with psychotic feature. Recently, it seems that more people are diagnosed as mood disorder with psychotic feature rather than schizoaffective disorder when they are showing concurrent psychotic and mood symptoms. This may be due to unwillingness to make severe diagnosis at first and aggressive trend to expand the diagnostic criteria for bipolar disorder. Over-diagnosis of mood disorder with psychotic feature would expose the patients to unnecessary mood stabilizer. Therefore, it is critical to make exact diagnosis based on current diagnostic criteria and other relevant study findings. We conducted in-depth review into diagnostic criteria of DSM and ICD-10 for schizoaffective disorder and mood disorder with psychotic feature and other related studies comparing clinical features between the two disorders. As a result, important points helpful in differentiating the two disorders are highlighted and future suggestions are described.
Figures and Tables
Fig. 1
Longitudinal course of schizoaffective disorder, bipolar type and bipolar disorder with psychotic features. a. Bipolar disorder with psychotic features, b. Schizoaffective disorder, bipolar type.
Fig. 2
Longitudinal course of schizoaffective disorder, depressive type, major depressive disorder with psychotic features, postschizophrenic depression and schizophrenia. a. Major depressive disorder with psychotic features, b. Schizoaffective disorder, depressive type. c. Potschizophrenic depression, d. Negative symptoms.
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