Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms

Background It is unclear whether outcome in schizoaffective disorders is more similar to schizophrenia or affective disorders. Aims To provide longitudinal data on clinical course and outcome in schizophrenia or affective disorders versus schizophrenia and affective disorders, and determine whether mood-incongruent psychotic symptoms have negative prognostic implications. Method A total of 210 patients with schizoaffective disorders, schizophrenia, bipolar manic-disorders and depression were assessed at hospitalisation and then followed up four times over 10 years. Results At all four follow-ups, fewer patients with schizoaffective disorders than with schizophrenia showed uniformly poor outcome. Patients with mood-incongruent psychotic symptoms during index hospitalisation showed significantly poorer subsequent outcome (P < 0.05). Conclusions Schizoaffective outcome was better than schizophrenic outcome and poorer than outcome for psychotic affective disorders. Mood-incongruent psychotic symptoms have negative prognostic implications. The results could fit a symptom dimension view of schizoaffective course. Declaration of interest Supported by a research grant from the National institute of Mental Health, USA.