Long-term course of schizoaffective disorders. Part I: Definitions, methods, frequency of episodes and cycles

The present study (Cologne study) investigated the long-term course (means = 25.6 years, minimum 10, maximum 59 years) of 72 schizoaffective patients. The diagnosis was based on the longitudinal approach. All patients were interviewed personally, using the Present State Examination and a pool of questions based on some instruments of the WHO (DAS, PIRS, etc.). The course was found to be usually polyphasic (more than 3 episodes) and only exceptionally monophasic (1 episode). For the purposes of statistical analysis an episode was considered in terms of time between the beginning and ending of inpatient or inpatient-like treatment. The number of episodes and cycles were found to be independent from premorbid and sociodemographic variables. But a significant relation was found between number of episodes (and cycles) and (a) polarity of the affective symptomatology, (b) presence of psychotic productive symptoms, (c) polymorphous course, (d) age at onset, and (e) duration of activity of the illness. It can be said that schizoaffective disorders are recurrent whereby the frequency of relapses is higher in bipolar than in unipolar types.