Summary
The influence of symptomatological and non-symptomatological factors on the long-term outcome of schizoaffective and schizophrenic disorders was investigated using the Analysis of Linear Structural Relationships (LISREL). The outcome was assessed employing the GAS, WHO/DAS, PIRS and the Bonn Criteria of Outcome. The analysis produced some interesting results in both groups, separately and in comparison with each other. The most striking difference between the two disorders concerns the finding that only symptomatological parameters directly influence the long-term outcome of schizoaffective disorders — melancholic episodes are correlated with favourable outcome, symptoms typical of schizophrenia with a relatively unfavourable outcome. Both symptomatological parameters (such as schizophrenic first-rank symptoms during course) and non-symptomatological parameters (such as life events or acuteness of onset) have a direct impact on the outcome. It was also found that “simple” depressive symptomatology (the presence of depressive symptoms not fulfilling the criteria of melancholic episodes according to DSM-III-R) has no influence on the long-term outcome of schizophrenia.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Angst J (1986) The course of schizoaffective disorders. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York
Angst J (1989) Der Verlauf schizoaffektiver Psychosen. In: Marneros A (ed) Therapie und Prophylaxe schizoaffektiver Psychosen. Springer, Berlin Heidelberg New York
Biehl H, Maurer K, Jablensky A, Cooper JE, Tomov T (1989) The PIRS/WHO. I. Introducing a new instrument for rating observed behaviour and the rationales of the psychological impairment concept. Br J Psychiatry (in press)
Bleuler M (1973) Die Schizophrenien: die langen Verldufe und ihre Formbarkeit. In: Huber G (ed) Verlauf und Ausgang schizophrener Erkrankungen. Schattauer, Stuttgart
Ciompi L, Müller C (1976) Lebensweg und Alter der Schizophrenen. Eine katamnestische Langzeitstudie bis ins Senium. Springer, Berlin Heidelberg New York
Endicott J, Spitzer RL, Fleiss JL, Cohen J (1976) The Global Assessment Scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 33:766–771
Gaebel W, Pietzcker A, Poppenberg A (1981) Prädiktoren des Verlaufes schizophrener Erkrankungen unter neuroleptischer Langzeitmedikation. Pharmacopsychiatry 14:180–188
Gross G, Huber G, Armbruster B (1986) Schizoaffective psychoses — long-term prognosis and symptomatology. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York
Harding C, Strauss J (1984) How serious is schizophrenia? Comments on prognosis. Biol Psychiatr 19:597–600
Hollingshead AB, Redlich FC (1958) Social class and mental illness. Wiley, New York
Huber G, Gross G, Schüttler R (1979) Schizophrenie. Springer, Berlin Heidelberg New York
Jöreskog KG, Sörbom D (1987) LISREL VII: analysis of linear structural relationships by maximum likelihood, instrumental variables, and least square methods. Users guide. University of Uppsala, Uppsala
Jöreskog KG, Thillo M van (1973) LISREL. A general computer program for estimating a linear structural equation system involving multiple indicators of unmeasured variables. Princeton University Press, Princeton, NJ
Kleining G, Moore H (1968) Soziale Selbsteinstufung (SSE) — Ein Instrument zur Messung sozialer Schichten. Köln Z Soziol Sozialpsychol 20: 502–552
Loyd D, Simpson J, Tsuang MT (1985) Are there sex differences in the long-term outcome of schizophrenia? Comparison with mania, depression, and surgical controls. J Nerv Ment Dis 173:643–649
Marneros A, Tsuang MT (eds) (1986a) Schizoaffective psychoses. Springer, Berlin Heidelberg New York
Marneros A, Tsuang MT (1986b) Schizoaffective disorders: present level and future perspective. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York
Marneros A, Deister A, Rohde A (1986a) The Cologne Study on schizoaffective disorders and schizophrenia suspecta. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York
Marneros A, Rohde A, Deister A, Risse A (1986b) Schizoaffective disorders: the prognostic value of the affective component. In: Marneros A, Tsuang MT (eds) Schizoaffective psychoses. Springer, Berlin Heidelberg New York
Marneros A, Deister A, Rohde A, Jünemann H, Fimmers R (1988a) Long-term course of schizoaffective disorders. Part I. Definitions, methods, frequency of episodes and cycles. Eur Arch Psychiatr Neurol Sci 237:264–275
Marneros A, Rohde A, Deister A, Jünemann H, Fimmers R (1988b) Long-term course of schizoaffective disorders. Part II. Length of cycles, episodes and intervals. Eur Arch Psychiatr Neurol Sci 237:276–282
Marneros A, Rohde A, Deister A, Fimmers R, Jünemann H (1988c) Long-term course of schizoaffective disorders. Part III. Onset, type of episodes and syndrome shift, precipitating factors, suicidality, seasonality, inactivity of illness and outcome. Eur Arch Psychiatr Neurol Sci 237: 283–290
Marneros A, Deister A, Rohde A (1988d) Syndrome shift in long-term course of schizoaffective disorders. Eur Arch Psychiatr Neurol Sci 238:97–104
Marneros A, Deister A, Rohde A (1988e) Quality of affective symptomatology and its importance for the definition of schizoaffective disorders. Psychopathology (in press)
Marneros A, Deister A, Rohde A, Steinmeyer A, Jünemann H (1989a) Long-term outcome of schizoaffective and schizophrenic disorders. A comparative study. I. Definitions, methods, psychopathological and social outcome. Eur Arch Psychiatr Neurol Sci 238:118–125
Marneros A, Steinmeyer EM, Deister A, Rohde A, Jünemann H (1989b) Long-term outcome of schizoaffective and schizophrenic disorders. A comparative study. III. Social consequences. Eur Arch Psychiatr Neurol Sci 238:135–139
Marneros A, Rohde A, Deister A, Steinmeyer EM (1989c) Prämorbide und Soziale Merkmale bei Patienten mit Schizoaffektiven Psychosen. Fortschr Neurol Psychiatr (in press)
McCabe M, Fowler R, Cadoret R, Winokur G (1972) Symptom differences in schizophrenia with good and poor prognosis. Am J Psychiatr 128:1239–1243
McGlashan T (1986) Predictors of shorter-, medium- and longterm outcome in schizophrenia. Am J Psychiatr 143:50–55
Müller HJ, Zerssen D von (1986) Der Verlauf schizophrener Psychosen unter den gegenwärtigen Behandlungsbedingungen. Springer, Berlin Heidelberg New York
Schubart C, Krumm B, Biehl H, Schwarz R (1986a) Measurement of social disability in a schizophrenic patient group. Soc Psychiatry 21:1–9
Schubart C, Schwarz R, Krumm B, Biehl H (1986b) Schizophrenie und soziale Anpassung. Springer, Berlin Heidelberg New York
Seeman MV (1986) Current outcome in schizophrenia: women vs. men. Acta Psychiatr Scand 73:609–617
Silverstein L, Harrow M (1981) Schneiderian first-rank symptoms in schizophrenia. Arch Gen Psychiatry 38:288–293
Spitzer RL, Gibbon M, Endicott J (1976) The global assessment scale. Arch Gen Psychiatry 33:768
World Health Organization (WHO) (1988) Psychiatric Disability Assessment Schedule (WHO/DAS). WHO, Geneva
Author information
Authors and Affiliations
Additional information
Supported by German Research Association (Deutsche Forschungsgemeinschaft) grants Ma 915-1/1 and Ma 915-1/2
Rights and permissions
About this article
Cite this article
Steinmeyer, E.M., Marneros, A., Deister, A. et al. Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. Eur Arch Psychiatr Neurol Sci 238, 126–134 (1989). https://doi.org/10.1007/BF00450999
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00450999