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8 - Schizoaffective mixed states

Published online by Cambridge University Press:  10 August 2009

Andreas Marneros
Affiliation:
Martin-Luther University Halle-Wittenberg Halle Germany
Stephan Röttig
Affiliation:
Martin-Luther University Halle-Wittenberg Halle Germany
Andrea Wenzel
Affiliation:
Martin-Luther University Halle-Wittenberg Halle Germany
Raffaela Blöink
Affiliation:
Martin-Luther University Halle-Wittenberg Halle Germany
Peter Brieger
Affiliation:
Martin-Luther University Halle-Wittenberg Halle Germany
Andreas Marneros
Affiliation:
Martin Luther-Universität Halle-Wittenburg, Germany
Frederick Goodwin
Affiliation:
George Washington University, Washington DC
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Summary

Introduction

Hardly any studies on schizoaffective mixed states exists. However, an exception is the Cologne study carried out by Marneros et al. in the 1980s and 1990s (Marneros et al., 1991). The rarity of research on schizoaffective mixed states is, on the one hand, a paradox, but on the other hand, an understandable phenomenon. Why a paradox? There are two reasons: first, while schizoaffective disorders are well established as diagnostic categories in both Tenth Revision of the International Classification of Diseases (ICD-10: World Health Organization, 1991) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV: American Psychiatric Association, 1994), it has also been determined that schizoaffective disorders have to be divided according to their mood component into unipolar and bipolar types, a fact that implicates the occurrence of schizoaffective mixed states (American Psychiatric Association, 1994; Marneros et al., 1989a–c; 1990a, 1990b; 1991; Marneros and Angst, 2000). Second, both diagnostic systems, ICD-10 and DSM-IV, define a schizoaffective mixed episode, as shown in Tables 8.1 and 8.2. Therefore, it is to be expected that clinicians and researchers applying either ICD-10 or DSM-IV criteria diagnose schizoaffective mixed episode. But neither clinical nor practical experience, as well as a study of the literature, supports such an assumption.

Then, why do these obvious deficits seem understandable? Mainly due to two reasons: first, the definition of schizoaffective disorders is – in spite of their long history and clinical reality – still diffuse and uncertain.

Type
Chapter
Information
Bipolar Disorders
Mixed States, Rapid Cycling and Atypical Forms
, pp. 187 - 206
Publisher: Cambridge University Press
Print publication year: 2005

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